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多元文化人群中疼痛性糖尿病周围神经病变影响的观点

Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population.

作者信息

Eichholz Martin, Alexander Andrea H, Cappelleri Joseph C, Hlavacek Patrick, Parsons Bruce, Sadosky Alesia, Tuchman Michael M

机构信息

Kelton Communications, Culver City, CA USA.

Pfizer Inc., 235 East 42nd Street, New York, NY 10017 USA.

出版信息

Clin Diabetes Endocrinol. 2017 Dec 28;3:12. doi: 10.1186/s40842-017-0051-2. eCollection 2017.

Abstract

BACKGROUND

Since few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations.

METHODS

Kelton fielded a survey by phone or Internet, in English or Spanish, among adults with pDPN symptoms in the United States between August and October 2015; African-Americans and Hispanics were oversampled to achieve at least 500 subjects for each group. Patients were required to have been diagnosed with pDPN or score ≥ 3 on ID Pain validated screening tool. The survey elicited information on pDPN symptoms and interactions with healthcare providers (HCPs), and included the Brief Pain Inventory and pain-specific Work Productivity and Assessment Questionnaire (WPAI:SHP).

RESULTS

Respondents included 823 Caucasians, 525 African-Americans, and 537 Hispanics; approximately half of African-Americans and Hispanics were <40 years of age, vs 12% of Caucasians. Pain was less likely to be rated moderate or severe by African-Americans (65%) and Hispanics (49%) relative to Caucasians (87%;  < 0.05). African-Americans and Hispanics were less likely than Caucasians to report experiencing specific pDPN sensory symptoms. Significantly fewer African-Americans and Hispanics reported receiving a pDPN diagnosis relative to Caucasians ( < 0.05), and higher proportions of African-Americans and Hispanics reported difficulty communicating with their HCP ( < 0.05). WPAI:SHP activity impairment was lower in Hispanics (43%) relative to African-Americans (53%) and Caucasian (56%;  < 0.05).

CONCLUSIONS

Multicultural patients reported differences in pDPN symptoms and pain relative to Caucasians, and fewer received a pDPN diagnosis. While further evaluation is needed to understand these differences, these data suggest a need to broaden pDPN educational initiatives to improve patient-HCP dialogue and encourage discussion of pDPN symptoms and their impact in a multicultural setting.

摘要

背景

由于很少有研究对多元文化人群中疼痛性糖尿病周围神经病变(pDPN)症状进行特征描述,本研究开展了一项调查,以更好地了解pDPN及其在非裔美国人、白种人和西班牙裔人群中的影响。

方法

2015年8月至10月期间,凯尔顿通过电话或互联网,以英语或西班牙语对美国有pDPN症状的成年人进行了一项调查;对非裔美国人和西班牙裔进行了过度抽样,以使每组至少有500名受试者。患者需被诊断为pDPN或在ID Pain有效筛查工具上得分≥3分。该调查收集了有关pDPN症状以及与医疗服务提供者(HCP)互动的信息,包括简明疼痛量表和疼痛特定的工作效率与评估问卷(WPAI:SHP)。

结果

受访者包括823名白种人、525名非裔美国人以及537名西班牙裔;非裔美国人和西班牙裔中约有一半年龄小于40岁,而白种人中这一比例为12%。与白种人(87%;P<0.05)相比,非裔美国人(65%)和西班牙裔(49%)将疼痛评为中度或重度的可能性较小。与白种人相比,非裔美国人和西班牙裔报告出现特定pDPN感觉症状的可能性较小。与白种人相比,报告被诊断为pDPN的非裔美国人和西班牙裔明显更少(P<0.05),且有更高比例的非裔美国人和西班牙裔报告在与他们的HCP沟通时有困难(P<0.05)。西班牙裔(43%)的WPAI:SHP活动障碍低于非裔美国人(53%)和白种人(56%;P<0.05)。

结论

多元文化患者报告的pDPN症状和疼痛与白种人存在差异,且被诊断为pDPN的人数更少。虽然需要进一步评估以了解这些差异,但这些数据表明有必要扩大pDPN教育举措,以改善患者与HCP之间的对话,并鼓励在多元文化背景下讨论pDPN症状及其影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28e/5745600/1b3155224910/40842_2017_51_Fig1_HTML.jpg

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