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Pharmacological target therapy of neuropathic pain and patient-reported outcomes in patients with chronic low back pain in Korea: Results from the NLBP Outcomes Research.

Authors
 Jae Taek Hong  ;  Jin-Hwan Kim  ;  Keun-Su Kim  ;  Chong-Suh Lee  ;  Hyun-Chul Shin  ;  Woo-Kyung Kim  ;  Joo-Han Kim  ;  Jung-Kil Lee  ;  In-Soo Kim  ;  Yoon Ha  ;  Soo-Bin Im  ;  Sang Woo Kim  ;  In-Ho Han  ;  Jun-Jae Shin  ;  ByeongCheol Rim  ;  Kyung-Soo Suk  ;  Jin-Hyok Kim  ;  Ye-Soo Park  ;  Bong-Soon Chang  ;  Deuk Soo Jun  ;  Young-Hoon Kim  ;  Jung-Hee Lee  ;  Woo-Kie Min  ;  Jung Sub Lee  ;  Si-Young Park  ;  In-Soo Oh  ;  Jae-Young Hong  ;  Bo-Jeong Seo  ;  Young-Joo Kim  ;  Juneyoung Lee 
Citation
 Medicine, Vol.97(35) : e11919, 2018 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2018
MeSH
Analgesics/therapeutic use* ; Chronic Pain/drug therapy* ; Cross-Sectional Studies ; Disability Evaluation ; Female ; Humans ; Low Back Pain/drug therapy* ; Male ; Middle Aged ; Neuralgia/drug therapy* ; Pain Measurement ; Patient Reported Outcome Measures* ; Quality of Life ; Republic of Korea ; Treatment Outcome
Abstract
A number of studies have demonstrated an association of neuropathic pain and chronic low back pain (CLBP), but the outcome difference in each medical management is poorly understood. This study is aimed to investigate treatment patterns of neuropathic pain in CLBP patients and to explore patient-reported outcomes (PROs) including quality of life (QoL) and functional disability by treatment patterns.Data were extracted from the neuropathic low back pain (NLBP) outcomes research. It was a multicenter and cross-sectional study in which 1200 patients were enrolled at 27 general hospitals, from 2014 to 2015. Of total, 478 patients classified as neuropathic pain were used for this subgroup analysis. The patients were divided into 2 groups according to treatment patterns (with vs. without the targeted therapy [TT] of neuropathic pain). Demographic and clinical features were collected by chart reviews and PROs were measured by patient's survey. QoL was assessed by EuroQoL 5-dimension (EQ-5D) questionnaire. Functional disability was measured by the Quebec Back Pain Disability Scale (QBPDS). Multiple linear regression analyses were conducted to compare the PROs between TT group and non-targeted therapy (nTT) group.Among the NLBP patients (mean age 63years, female 62%), EQ-5D index, EuroQoL-Visual Analog Scale (EQ-VAS), and QBPDS Scores (mean ± standard deviation) were 0.40 ± 0.28, 54.98 ± 19.98, and 46.03 ± 21.24, respectively. Only 142 (29.7%) patients had pharmacological TT of neuropathic pain. Univariate analyses revealed no significant mean differences between TT group and nTT group in the EQ-5D index (0.41 ± 0.27 and 0.39 ± 0.28), EQ-VAS (56.43 ± 18.17 and 54.37 ± 20.69), and QBPDS (45.31 ± 21.32 and 46.31 ± 21.24). After adjustment with covariates, TT group had higher scores of EQ-5D index (β = 0.07; P < 0.01) and EQ-VAS (β = 4.59; P < 0.05) than the nTT group. The TT group's QBPDS score was lower than the nTT group, although its statistical significance still has not been reached (β = -4.13; P = 0.07).We found that considerable proportion of the NLBP patients remains untreated or undertreated. Although TT group had significantly better QoL than nTT group, only 29.7% of NLBP patients had pharmacological TT. Therefore, clinicians should consider using TT for better QoL of neuropathic pain patients.
Files in This Item:
T201804068.pdf Download
DOI
10.1097/MD.0000000000011919
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
김근수(Kim, Keun Su) ORCID logo https://orcid.org/0000-0002-3384-5638
석경수(Suk, Kyung Soo) ORCID logo https://orcid.org/0000-0003-0633-2658
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165481
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