title: Painful diabetic peripheral neuropathy: results of a survey characterizing the perspectives and misperceptions of patients and healthcare practitioners.
abstract: BACKGROUND
  Little information exists on the understanding and management of painful diabetic peripheral neuropathy (pDPN) between patients and healthcare practitioners (HCPs).
  
  
  OBJECTIVE
  The objective of this study was to characterize the patient perspective of pDPN and identify gaps in patient and HCP perceptions of pDPN.
  
  
  METHODS
  An online survey of patients with type 1 or 2 diabetes mellitus who reported experiencing any symptoms consistent with diabetic peripheral neuropathy (DPN) and HCPs who treat diabetes was conducted in 2012 in the USA. Patients were recruited via the Survey Sampling national consumer research panel, and HCPs were recruited from Epocrates' national research panel. Survey questions focused on the impact, understanding, and management of pDPN, and interactions between patients and their HCPs. Respondents who reported pain were re-contacted to obtain further information on pain severity using a numerical rating scale (0 = no pain, 10 = most pain).
  
  
  RESULTS
  Respondents included 1,004 patients (53 % female, average age 55 years) and 500 HCPs (250 generalists, 150 specialists, and 100 nurses/physician assistants). While 83 % of patients reported pDPN symptoms, only 41 % of these patients had been diagnosed with DPN. Eighty-five percent of those with pDPN reported that it impacts daily activities. In contrast, HCPs estimated that of their patients who experienced any type of DPN symptom, 41 % experienced pain and 38 % had daily activity limitations because of their symptoms. Most HCPs (64 %) never had their patients complete a DPN assessment questionnaire, and only 41 % perform specific diagnostic tests on all patients who report DPN symptoms. Patients and HCPs both showed substantial clinical misperceptions regarding the cause and management of pDPN; 53 % of HCPs believed that adequate blood glucose control could reverse DPN, and 43 % of pDPN patients were not sure if DPN was reversible. There was also substantial discordance between patients and HCPs regarding discussions of DPN; only 49 % of pDPN patients reported that they speak about symptoms at "every" or "most" appointments with their HCP but 73 % of HCPs reported discussing DPN symptoms at "every" or "most" visits.
  
  
  CONCLUSIONS
  Not only do misperceptions exist on the cause and management of pDPN among patients and HCPs, but there are additional disparities between the patient and HCP perspectives. These results suggests a need for (1) educational initiatives on pDPN that target patients and HCPs, and (2) initiating improved dialogue between patients and their HCPs for discussing appropriate management of pDPN that is distinct from treatment of the underlying diabetes.
authors.affiliation: Pfizer, Inc., 235 East 42nd Street, New York, NY, 10017, USA, alesia.sadosky@pfizer.com.
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.forename: Joe
authors.initials: J
authors.lastname: Hopper
authors.forename: Bruce
authors.initials: B
authors.lastname: Parsons
mesh_terms: D048909:Diabetes Complications / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010361:Patients; D010465:Perception; D010820:Physicians; D011788:Quality of Life