Diagnosis Often Takes a Year or More Even After Seeing a Physician
LONDON, March 1 /CNW/ - A new seven-country global survey reveals that
effective patient-physician communication is key to earlier, accurate
diagnosis and treatment for patients with neuropathic pain (NeP). NeP is a
debilitating condition characterised by chronic, often severe nerve pain and
is often a complication of common conditions including diabetes, herpes,
cancer, HIV, multiple sclerosis, stroke, traumatic injury or surgery. The
survey results, released today by the Neuropathic Pain Network (NPN), a
coalition of patient advocacy organisations, found that in some countries
patients wait up to 19 months on average and visit as many as two or more
doctors before they receive an accurate diagnosis. Countries surveyed included
the United Kingdom, Germany, Italy, Korea, Mexico, Spain and Finland.
Neuropathic Pain Difficult to Recognise
Many patients need to visit more than one physician before their pain is
recognised as neuropathic pain. Of physicians surveyed in the seven countries,
the majority of whom were general practitioners, most do not find it very easy
to recognise neuropathic pain. A majority of physicians in all countries
report that a main factor in the delay is difficulty differentiating NeP from
other pain conditions. This is important because treatments that may be
effective in other types of pain often do not provide relief for NeP patients.
Patient and Physician Checklist: Cover Three Key Areas
According to the survey, patients wait on average between 5.7 to 19.5
months after they experience their first symptom before going to a physician;
most patients believe the pain will 'go away by itself.' Once patients consult
a physician about their pain, limited or ineffective communication can further
delay recognition of neuropathic pain.
The survey found that physicians who recognise their patient's NeP are
more likely to discuss the following three key areas with their patient.
Physicians who do not ask questions covering these three key areas are less
likely to identify their patient's condition as neuropathic pain.
1. Symptom Characteristics: Characterise the intensity and duration and
describe how the pain feels with specific adjectives (e.g. "pins and
needles," "burning," "stabbing," "numb," or "like electrical shocks")
2. Medical History: Share all medical history; NeP can be a
complication of diabetes, herpes, cancer, HIV, traumatic injury or
3. Location of Pain in the Body: Explain where on the body the pain is
"Crippling neuropathic pain affects every aspect of patients' lives,
often even limiting their ability to work, and yet it is typically
under-diagnosed," said Ian Semmons, Board Member, Neuropathic Pain Network and
Chairman, UK Action on Pain. "The survey suggests there are things patients
can do to hasten their diagnosis and treatment. By sharing their pain symptom
characteristics, medical history and location of pain in their body, patients
can help their physicians more readily differentiate if their pain is
neuropathic. We urge all pain patients, particularly those with diabetes,
herpes, cancer or HIV to discuss these topics with their physicians."
Screening Tools Not Widely Used
To help physicians screen patients with pain, researchers have developed
questionnaires for patients to complete in the waiting room prior to seeing
the physician. Patients answer several questions about their pain experience,
including questions covering the key topics uncovered in the survey. The tools
can assist physicians in making a rapid, yet detailed assessment of a
patient's pain experience. Of the seven countries in the survey, only in
Mexico do a majority of physicians currently use available screening tools for
most or all of their patients, although in all countries, there is great
interest among physicians to learn more about them.
"In many countries, physicians have increasingly limited time with
patients, posing a particular challenge with neuropathic pain, which has been
historically difficult to identify," said Michael Bennett, M.D., Senior
Clinical Lecturer in Palliative Medicine and Honorary Senior Research Fellow,
University of Leeds, Leeds, UK. "For these physicians, screening tools may be
one solution, alerting physicians to the possibility of neuropathic pain in a
timely manner. Whether through the use of these tools, or by simply engaging
in thorough conversations, improving communication about symptoms of
neuropathic pain can help us meet the needs of these long-suffering patients."
Neuropathic Pain: A Debilitating Condition
Neuropathic pain is a debilitating condition that is estimated to impact
between 2.8 percent and 4.7 percent of people globally. NeP can have a
significant impact on patients' lives, leaving many unable to work, walk or
even wear clothes, as contact with their skin can cause an unbearable burning
pain. Neuropathic pain is often under-diagnosed and under-treated. NeP is
initiated or caused by a lesion or dysfunction of the nervous system (either
peripheral or central). Patients often describe their symptoms as burning,
stabbing or shock-like sensations. In recent years, a number of screening
tools (e.g., Pain DETECT, LANSS, DN4, ID Pain) have been developed to help
physicians identify this often-elusive condition.
About the Survey
In July 2006, the Neuropathic Pain Network and Pfizer Inc commissioned
Harris Interactive to conduct a multi-country survey of NeP patients and the
physicians who treat them. A survey of approximately 700 diagnosed NeP
patients and 700 physicians was conducted in seven countries including:
Finland, Germany, Korea, Italy, Mexico, Spain and UK. Fieldwork was conducted
from August 18, 2006 through January 29, 2007. The results of any survey are
subject to sampling variation. For a sample of 100, maximum potential sampling
variation is + or - eight percentage points at the 95% confidence level.
Funding for the survey was provided by Pfizer Inc.
About the Neuropathic Pain Network
The Neuropathic Pain Network (NPN) is a coalition of organisations that
actively support people with neuropathic pain by enabling them to cope better
with their pain, to obtain the best treatment and, ultimately, to improve the
quality of their lives. The NPN has developed the first website solely
dedicated to providing support for people with neuropathic (nerve) pain.
For further information:
For further information: Sejal Sedani, Resolute Communications,