title: Burden of spinal cord injury-related neuropathic pain in the United States: retrospective chart review and cross-sectional survey.
abstract: METHODS
  Cross-sectional, observational study.
  
  
  OBJECTIVE
  Characterize demographic and clinical characteristics, health status, pain, function, productivity and economic burden in spinal cord injury-related neuropathic pain (SCI-NeP) subjects, by pain severity.
  
  
  METHODS
  United States. One hundred and three subjects diagnosed with SCI-NeP recruited during routine primary care or specialty physician office visits completed a questionnaire to assess patient-reported outcomes. Physicians completed a case report form on inclusion/exclusion criteria, subject clinical characteristics and health-care resource use (HRU) based on 6-month retrospective chart review.
  
  
  RESULTS
  Subjects' mean age was 48.7, 69.9% were male and 48.5% were unable to walk. The most frequently reported comorbidities were sleep disturbance/insomnia (28.2%), depressive symptoms (25.2%) and anxiety (23.3%). Subjects' mean pain severity score was 5.3 (0-10 scale), and 77.7% reported moderate or severe pain. On a 0-10 scale, subjects' reported moderate pain interference with function: mean 5.4. Subjects' health status, as measured by the EuroQol 5-dimensions health-state utility, was 0.49 (-0.11 to 1.00 scale). Pain interference with function and health status were significantly worse among subjects with more severe pain (P<0.0005). Among employed subjects (13.6%), overall work impairment was 38.0%. The proportion of subjects who were prescribed ≥1 medication was 94.2%, and the mean number of physician office visits in past 6 months due to SCI-NeP was 2.2. Total annualized cost per subject was $26 270 (direct: $8636, indirect: $17 634).
  
  
  CONCLUSIONS
  SCI-NeP subjects exhibited high pain levels, despite active management. Pain levels were associated with poor function, low health status and lost productivity. HRU was prevalent, and costs, particularly indirect, were substantial, highlighting unmet need.
  
  
  BACKGROUND
  This study was supported by Pfizer, Inc.
authors.affiliation: Covance Market Access Services Inc., San Diego, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Mann
authors.forename: C
authors.initials: C
authors.lastname: Schaefer
authors.forename: A
authors.initials: A
authors.lastname: Sadosky
authors.forename: F
authors.initials: F
authors.lastname: Bergstrom
authors.forename: R
authors.initials: R
authors.lastname: Baik
authors.forename: B
authors.initials: B
authors.lastname: Parsons
authors.forename: S
authors.initials: S
authors.lastname: Nalamachu
authors.forename: B R
authors.initials: BR
authors.lastname: Stacey
authors.forename: M
authors.initials: M
authors.lastname: Tuchman
authors.forename: A
authors.initials: A
authors.lastname: Anschel
authors.forename: E C
authors.initials: EC
authors.lastname: Nieshoff
mesh_terms: D001007:Anxiety / Q000191:economics* / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003625:Data Collection; D003863:Depression / Q000191:economics* / Q000453:epidemiology; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data; D012893:Sleep Wake Disorders / Q000191:economics* / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology