title: Burden of illness associated with peripheral and central neuropathic pain among adults seeking treatment in the United States: a patient-centered evaluation.
abstract: OBJECTIVE
  The aim of this study was to evaluate patient-reported burden associated with peripheral and central neuropathic pain (NeP) by pain severity and NeP condition.
  
  
  METHODS
  Six hundred twenty-four subjects with one of six NeP conditions were recruited during routine office visits. Subjects consented to retrospective chart review and completed a one-time questionnaire (including EuroQol-5 dimensions, 12-item Short-Form Health Survey, Brief Pain Inventory-Short Form, Medical Outcomes Study Sleep Scale, Hospital Anxiety and Depression Scale, and demographic and clinical characteristics). Pain severity scores were used to stratify subjects by mild, moderate, and severe pain. Summary statistics and frequency distributions were calculated. Differences by severity level were compared using Kruskal-Wallis (continuous variables) and chi-square or Fisher's exact test (categorical variables). Effect size was computed with Cohen's d (mild vs severe).
  
  
  RESULTS
  Subjects' mean age was 55.5. The majority (80.8%) had moderate or severe pain. Patient-reported outcomes (health status, physical and mental health, pain interference with function, sleep, anxiety, and depression) were significantly worse among subjects with greater pain severity (all P < 0.0001). Severe pain subjects were negatively impacted by ≥30% in each outcome compared with mild pain subjects; standardized effect size was moderate for anxiety (0.59) and large (>0.95) for all others. The observed burden was most substantial among chronic low back pain-NeP, although the pattern of disease burden was similar across the six NeP conditions.
  
  
  CONCLUSIONS
  Subjects across NeP conditions exhibited high pain levels, which were significantly associated with poor function, compromised health status and sleep, and increased anxiety and depression. Results indicate substantial patient burden across broad NeP, particularly among subjects with severe pain.
authors.affiliation: Covance Market Access Services Inc., Gaithersburg, Maryland, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Schaefer
authors.forename: Rachael
authors.initials: R
authors.lastname: Mann
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.forename: Shoshana
authors.initials: S
authors.lastname: Daniel
authors.forename: Bruce
authors.initials: B
authors.lastname: Parsons
authors.forename: Edward
authors.initials: E
authors.lastname: Nieshoff
authors.forename: Michael
authors.initials: M
authors.lastname: Tuchman
authors.forename: Srinivas
authors.initials: S
authors.lastname: Nalamachu
authors.forename: Alan
authors.initials: A
authors.lastname: Anschel
authors.forename: Brett R
authors.initials: BR
authors.lastname: Stacey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Burden of Illness; Health Status; Health-Related Quality of Life; Neuropathic Pain; Pain Assessment; Patient-Reported Outcomes