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Pharmacological Tre...
Pharmacological Treatment Patterns in Neuropathic Pain-Lessons from Swedish Administrative Registries
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- Gustavsson, Anders (author)
- Karolinska Institutet
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Bjorkman, Johan (author)
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Ljungcrantz, Christina (author)
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- Rhodin, Annica (author)
- Uppsala universitet,Anestesiologi och intensivvård
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Rivano-Fischer, Marcelo (author)
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- Sjolund, Karl-Fredrik (author)
- Karolinska Institutet
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Mannheimer, Clas (author)
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(creator_code:org_t)
- 2013-07-01
- 2013
- English.
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In: Pain medicine (Malden, Mass.). - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 14:7, s. 1072-1080
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Abstract
Subject headings
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- Objective. To explore the treatment patterns of patients with a diagnosis related to chronic pain (DRCP) initiating pharmacological treatment indicated for neuropathic pain (NeuP: tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and anticonvulsants). Design. Retrospective study on administrative registers. Setting. General population in Western Sweden (one sixth of the country). Subjects. All patients with a DRCP (N = 840,000) in years 2004-2009. Outcome Measures. Treatment sequence, continuation, switching, and comedication. Results. In total, 22,997 patients with a first NeuP in 2007 or 2008 were identified, out of which 2% also had epilepsy and 39% had a mood disorder. The remaining 13,749 patients were assumed to be treated for neuropathic pain, out of which 16% had a neuropathy diagnosis, 18% had a mixed pain diagnosis, and the remaining 66% had another DRCP. The most common first prescription was amitriptyline (40%) followed by pregabalin (22%) and gabapentin (19%). More than half had discontinued treatment after 3 months, and 60-70% at 6 months. Seven percent received another NeuP drug within 6 months of the discontinuation of their first NeuP treatment, 11% had another analgesic and 22% had a prescription indicating psychiatric comorbidity (selective serotonin reuptake inhibitors or benzodiazepine). Conclusions. Treatment initiation of currently available drugs indicated for neuropathic pain less frequently lead to long-term treatment in clinical practice compared with clinical trial, and few try more than one drug. We suggest our findings to be indications of a need for better routines in diagnosing patients to ascertain optimal treatment and follow-up.
Keyword
- Chronic Pain
- Tricyclic Antidepressants
- Serotonin-Norepinephrine Reuptake Inhibitors
- Anticonvulsants
- Treatment Pattern
- Psychiatric Comorbidity
Publication and Content Type
- ref (subject category)
- art (subject category)
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