Use of 5% lidocaine medicated plasters for the treatment of pain in routine hospital practice: patient reported pain, functioning and satisfaction.
OBJECTIVE
5% lidocaine medicated plasters are a topical option in the treatment of peripheral neuropathic pain, as monotherapy or as an adjunct to systemic medication. This study sought to determine the impact of lidocaine plaster use on self-reported pain, functioning and patient satisfaction within a large teaching hospital.


METHODS
Patients were selected from the pain and rheumatology outpatient departments in Cardiff, Wales (2008-9). Postal surveys were sent to patients prescribed lidocaine plaster asking whether patients currently used the plaster and, if not, reason for discontinuation. Patients were asked to record pain score before and after therapy initiation, percentage pain relief, duration of effectiveness and impact on functioning.


METHODS
Pain scores, pain relief and levels of functioning before and after treatment.


RESULTS
A total of 850 surveys were dispatched; 408 (48.0%) responses received; 197 (48.3%) patients were current users at survey completion. Median pain score prior to plaster use was 8 (IQR 7-9). One month after initiation, median pain score was 6 (4-8, p < 0.001) overall and 5 (4-7, p < 0.001) for current users. Median pain relief, after initial month of plaster use, was 30% (10-60%) for all patients and 50% (30-70%) for current users, whilst pain relief at time of survey was 30% (0-60%) and 50% (30-70%), respectively. A total of 181 (93.3%) current users claimed the plasters were effective. All three measures of functioning were significantly improved in current users: sleep (63.3% versus 20.1%, p < 0.001), mood (59.2% versus 18.6%, p < 0.001) and activity level (50.0% versus 19.5%, p < 0.001). Median satisfaction was 5 (IQR 1-8) for all patients and 7 (5-9) for current plaster users.


CONCLUSIONS
The results of this study need to be considered within the context of a self-reported survey. However, pain, functioning and patient satisfaction were significantly improved in current users of 5% lidocaine medicated plasters.
Department of Anaesthesia, Intensive Care and Pain Medicine, University Hospital of Wales , Cardiff , UK.
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Khot
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Morgan
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Kadambande
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Poole
D000279:Administration, Cutaneous; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004304:Dosage Forms; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D020127:Recovery of Function; D057566:Self Report; D016896:Treatment Outcome
D000779:Anesthetics, Local; D004304:Dosage Forms; D008012:Lidocaine
5% lidocaine medicated plaster; Local anesthesia; Neuropathic pain; Questionnaire; Treatment outcome