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诊断、管理和伴有疼痛的糖尿病周围神经病变的影响:四个欧洲国家的患者调查。

Diagnosis, management and impact of painful diabetic peripheral neuropathy: A patient survey in four European countries.

机构信息

Diabetes Research Unit, Royal Hallamshire Hospital, UK.

Institute of Pain Medicine, Tel Aviv Medical Center, Israel.

出版信息

J Diabetes Complications. 2023 Apr;37(4):108417. doi: 10.1016/j.jdiacomp.2023.108417. Epub 2023 Feb 10.

Abstract

AIMS

The aim of this study was to assess patient perspectives and experiences of the impact of neuropathic pain, painful diabetic neuropathy (pDPN) diagnosis and treatment, and the patient-healthcare professional (HCP) relationship.

METHODS

We conducted a quantitative online survey in Germany, the Netherlands, Spain, and the UK among adults with diabetes who responded "yes" to at least four of ten questions of in the Douleur Neuropathique en 4 Questions (DN4) questionnaire.

RESULTS

Of 3626 respondents, 576 met the eligibility criteria. Daily pain was rated as moderate or severe by 79 % of respondents. Most participants reported a negative impact of their pain on sleep (74 %), mood (71 %), exercise (69 %), concentration (64 %) and daily activities (62 %), and 75 % of those in employment had missed work because of their pain in the past year. Overall, 22 % of respondents avoided discussing pain with their HCP, 50 % had not received formal pDPN diagnosis, and 56 % had not used prescribed pain medications. Although two-thirds (67 %) of respondents reported feeling satisfied or very satisfied with treatment, 82 % of these patients still experienced daily moderate or severe pain.

CONCLUSIONS

Neuropathic pain in people with diabetes affects daily life and remains underdiagnosed and undertreated in clinical practice.

摘要

目的

本研究旨在评估神经病理性疼痛、糖尿病性周围神经痛(pDPN)诊断和治疗对患者的影响,以及患者与医疗保健专业人员(HCP)关系的患者观点和体验。

方法

我们在德国、荷兰、西班牙和英国进行了一项定量在线调查,纳入了在 Douleur Neuropathique en 4 Questions(DN4)问卷中至少回答了十个问题中的四个问题的糖尿病患者。

结果

在 3626 名受访者中,有 576 名符合入选标准。79%的受访者每天的疼痛被评为中度或重度。大多数参与者报告称疼痛对睡眠(74%)、情绪(71%)、运动(69%)、注意力(64%)和日常活动(62%)有负面影响,过去一年中,有 75%的在职患者因疼痛而缺勤。总体而言,22%的受访者避免与 HCP 讨论疼痛,50%的患者未接受过正式的 pDPN 诊断,56%的患者未使用规定的止痛药物。尽管三分之二(67%)的受访者表示对治疗感到满意或非常满意,但这些患者中有 82%仍每天经历中度或重度疼痛。

结论

糖尿病患者的神经病理性疼痛影响日常生活,在临床实践中仍存在诊断不足和治疗不足的情况。

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