Singh Vishal K, Shetty Yashashri C, Salins Naveen, Jain Parmanand
Department of Pharmacology and Therapeutics, Seth GSMC and KEMH, Mumbai, Maharashtra, India.
Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Indian J Palliat Care. 2020 Jan-Mar;26(1):13-18. doi: 10.4103/IJPC.IJPC_172_19. Epub 2020 Jan 28.
The objective of the present research was to evaluate the prescription pattern of the drugs used in the pharmacological treatment of cancer-related neuropathic pain (CRNP) and to assess the adherence of the physicians to the Neuropathic Pain Special Interest Group (NeuPSIG) Guidelines.
This was a cross-sectional, observational study where patients who presented to the pain and palliative care outpatient clinic of the tertiary care hospital with CRNP were prospectively recruited. Participants were screened for neuropathic pain using DN4 questionnaire. Demographic details, diagnosis, medication details, and adherence to NeuPSIG guidelines were assessed using a validated questionnaire.
Of 300 patients screened, 64% were male and 36% were female, with a mean age of 48.26 ± 13.05 years. The predominant symptoms found were pin-and-needle sensation (99%) followed by tingling sensation (98.66%). The most common diagnosis was head-and-neck cancers (37.3%) followed by bone cancers (17.3%) and lung cancers (15.3%). Among the first-line drugs recommended in NeuPSIG for CRNP, pregabalin (78.7%) was the most common drug prescribed followed by amitriptyline (67%). The most common co-prescribed drugs were acid suppressants drugs (50.7%). Tapentadol, which is not part of the NeuPSIG guidelines, was prescribed on 51 occasions for neuropathic pain. Underdosing was observed in 272 prescriptions. Only 12 prescriptions completely adhered, while 275 had partial, and 13 prescriptions had poor adherence to NeuPSIG guidelines.
The most commonly used drugs in the treatment of CRNP were pregabalin and amitriptyline. Most physician partially or did not adhere to the NeuPSIG guideline in the management of CRNP.
本研究的目的是评估用于癌症相关神经性疼痛（CRNP）药物治疗的用药模式，并评估医生对神经病理性疼痛特别兴趣小组（NeuPSIG）指南的遵循情况。
这是一项横断面观察性研究，前瞻性招募了到三级医院疼痛与姑息治疗门诊就诊的CRNP患者。使用DN4问卷对参与者进行神经性疼痛筛查。使用经过验证的问卷评估人口统计学细节、诊断、用药细节以及对NeuPSIG指南的遵循情况。
在筛查的300例患者中，64%为男性，36%为女性，平均年龄为48.26±13.05岁。发现的主要症状是针刺感（99%），其次是刺痛感（98.66%）。最常见的诊断是头颈癌（37.3%），其次是骨癌（17.3%）和肺癌（15.3%）。在NeuPSIG推荐用于CRNP的一线药物中，普瑞巴林（78.7%）是最常用的处方药，其次是阿米替林（67%）。最常见的联合处方药是抑酸药物（50.7%）。曲马多不属于NeuPSIG指南的一部分，有51次被用于治疗神经性疼痛。在272张处方中观察到用药剂量不足。只有12张处方完全遵循，275张部分遵循，13张处方对NeuPSIG指南的遵循情况较差。
治疗CRNP最常用的药物是普瑞巴林和阿米替林。大多数医生在CRNP的管理中部分或未遵循NeuPSIG指南。
