title: Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.
abstract: BACKGROUND
  The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US.
  
  
  METHODS
  This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.
  
  
  RESULTS
  The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0-10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0-10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0-100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $4841 and $9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect costs were significantly worse among subjects with more severe pain (P < 0.0020).
  
  
  CONCLUSIONS
  Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity. Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity. The burden of pDPN was greater among subjects with greater pain severity.
authors: Pfizer Inc, New York, N Y.
authors: Alesia
authors: A
authors: Sadosky
authors: Caroline
authors: C
authors: Schaefer
authors: Rachael
authors: R
authors: Mann
authors: Felicia
authors: F
authors: Bergstrom
authors: Rebecca
authors: R
authors: Baik
authors: Bruce
authors: B
authors: Parsons
authors: Srinivas
authors: S
authors: Nalamachu
authors: Edward
authors: E
authors: Nieshoff
authors: Brett R
authors: BR
authors: Stacey
authors: Alan
authors: A
authors: Anschel
authors: Michael
authors: M
authors: Tuchman
keywords: burden of illness; costs; health care resource use; pain assessment; painful diabetic peripheral neuropathy; productivity; quality of life; treatment patterns
references: Eur J Neurol. 2004 Mar;11(3):153-62
references: 15009162
references: Clin J Pain. 2006 Oct;22(8):681-5
references: 16988563
references: Pharmacoeconomics. 2009;27(2):95-112
references: 19254044
references: Pain. 2005 May;115(1-2):29-36
references: 15836967
references: Sleep Med. 2005 Jan;6(1):41-4
references: 15680294
references: Health Qual Life Outcomes. 2008 Dec 17;6:113
references: 19091084
references: Pharmacoeconomics. 2004;22(3):165-84
references: 14871164
references: J Pain Symptom Manage. 2005 Oct;30(4):374-85
references: 16256902
references: Br Med J (Clin Res Ed). 1986 Feb 1;292(6516):344
references: 3080166
references: Med Care. 1996 Mar;34(3):220-33
references: 8628042
references: Pain Med. 2011 Jan;12(1):118-26
references: 21087406
references: J Am Geriatr Soc. 2011 May;59(5):827-36
references: 21568954
references: Neurology. 2007 Apr 10;68(15):1178-82
references: 17420400
references: Curr Med Res Opin. 2009 Jun;25(6):1319-28
references: 19419344
references: Ann Med. 2001 Jul;33(5):337-43
references: 11491192
references: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references: 6880820
references: J Am Osteopath Assoc. 2005 Sep;105(9 Suppl 4):S12-9
references: 16273720
references: Pain Pract. 2008 Jan-Feb;8(1):45-56
references: 18211592
references: Ann Acad Med Singap. 1994 Mar;23(2):129-38
references: 8080219
references: Diabetes Metab Syndr Obes. 2011;4:401-8
references: 22253538
references: J Diabetes Complications. 2006 Jan-Feb;20(1):26-33
references: 16389164
references: Pharmacoeconomics. 1993 Nov;4(5):353-65
references: 10146874
references: Diabetes Care. 2004 Jul;27(7):1591-7
references: 15220233
references: Pain. 2009 Nov;146(1-2):34-40
references: 19592166
references: Med Care. 2005 Nov;43(11):1078-86
references: 16224300
references: J Pain. 2006 Dec;7(12):892-900
references: 17157775
references: Eur J Pain. 2006 Feb;10(2):127-35
references: 16310716