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Cited by 49Pain Mechanisms and TreatmentsHerpesvirus Infections and TreatmentsPain Management and Opioid Use

Is treatment of postherpetic neuralgia in the community consistent with evidence-based recommendations?

Dworkin, Robert H., Panarites, Christopher J., Armstrong, Edward P., Malone, Daniel C., Pham, Sissi V.·2012·Pain
DOI 10.1016/j.pain.2012.01.015
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Abstract

Few studies have examined the extent to which treatment of patients with neuropathic pain in the community is consistent with evidence-based treatment recommendations. U.S. health care claims were used to identify patients who received a diagnosis of postherpetic neuralgia (PHN). The initial pharmacologic treatments and changes to these treatment regimens were categorized according to the International Association for the Study of Pain Neuropathic Pain Special Interest Group recommendations for first-, second-, and third-line treatment of neuropathic pain. The results indicated that the treatment of PHN was only partially consistent with these treatment recommendations. Of the patients diagnosed with PHN who were not already on a specified treatment, 70% began treatment with either a first-, second-, or third-line treatment or a not-recommended treatment, and 30% did not begin treatment with any of these medications. Only one-quarter of patients began treatment with a first-line medication, the same percentage that began treatment with either a third-line medication or a not-recommended treatment. There was a wide range of initial treatment durations, but the means and medians suggest that patients and clinicians often decide to change the initial treatment within 2 months, either by discontinuing it, replacing it with a new medication, or adding a new medication. Although there were generally shorter treatment durations with opioid analgesics and tramadol, these medications were more frequently used in beginning treatment than the other treatments. The results suggest that a considerable number of patients with PHN in the community are not receiving evidence-based treatment.

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Authors
Dworkin, R. H., Panarites, C. J., Armstrong, E. P., Malone, D. C., & Pham, S. V.
Affiliations
  • University of Arizona (US)
  • Abbott Vascular (United States) (US)
Corresponding author
Dworkin, Robert H.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-04
Volume
153
Issue
4
Pages
869-875
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2012.01.015
OpenAlex
W2069938885
Cited by
49
References
43
Citations by year
2026: 2 · 2025: 9 · 2022: 1 · 2021: 3 · 2019: 5 · 2018: 5 · 2017: 1 · 2016: 2 · 2015: 5 · 2014: 4 · 2013: 7 · 2012: 5
FWCI
4.48
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • U.S. Food and Drug Administration
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
postherpetic neuralgia, neuropathic pain, evidence-based treatment, medication adherence, treatment guidelines, first-line therapy, opioid analgesics, tramadol, treatment duration, health insurance claims, community-based care
MeSH terms
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Residence Characteristics, Retrospective Studies, Treatment Outcome, Practice Guidelines as Topic, Evidence-Based Medicine, Neuralgia, Postherpetic

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