Patients’ Perception on Benefits of Medications for treating diabetic Peripheral Neuropathic Pain

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DOI: 10.21522/TIJCR.2014.04.02.Art002

Authors : Ahmed Mohamed Ali Yousif, Tag Eldin O. Sokrab, Isam Eldin Abdelbagi, Samah A. Mazin, Hassan Tawfik

Abstract:

Background: About 16% of the adult Qataris at ages of 20 to 79 were diabetic. The prevalence of peripheral diabetic neuropathy in Arabic ranged between 38-94% in diabetic. Medications in studied were Amitriptyline, Carbamazepine, Celecoxib, Diclofenac, Duloxetine, Fluoxetine, Gabapentin, Imipramine, Meloxicam, Paracetamol and pregabalin.

The specific objective; how the DPNP patients would perceive the benefits of medications Secondary objectives; which medication(s) perceived to restore a patient’s quality of life. In addition, which medications could realize a 50% benefits for releasing DPNP.

Setting: participants selected randomly, when attended their routine appointments in six health centers under in Qatar.

Sample size: 646 DPNP participants

Inclusion criteria: Diabetic from 18 years and above, taking medications to treat DPNP for duration of at least three weeks.

Exclusion criteria: Patients taking same medications for other ailments, diabetic less than 18 years old, and those with difficulty in communication. Results: Participants showed abilities to perceive the benefits of their medications, and their impact on some domains of quality of life. Gabapentin perceived by average percent of 70.70 % to be beneficial in the above mentioned domains. Imipramine perceived by 24% beneficial. Fluoxetine not completely perceived as beneficial. Nonsteroidal anti-inflammatory drugs studied perceived to be less than 50% beneficial. Conclusion: Patient’s perception on benefits of medications may be of high importance factor in medication selection. Anticonvulsants perceived to be more beneficial than other medications group. Recommendations: Consider patient’s preferences in selection medications.

Keywords: Patients’ perception, diabetic peripheral neuropathy medications.

References:

[1].     Abbas Al Jalabi, AE. Ayad, N. Ghaly, R. Ragab, S. Majeed, H. Nassar, A. AL Shoaibi, S. EL Noor, A. Salti, J. Costandi, AZ. Zeidan, SA. Schug. journal of international medical (August 2011). Journal of International Medical Research, August 2011; vol. 39, 4: pp. 1123-1141. http://imr.sagepub.com/search?author1=AE+Ayad&sortspec=date&submit=Submit

[2].     Aristidis Veves, Miroslav Backonja, Rayaz A. Malik, and (30- July 2007) Painful Diabetic Neuropathy: Epidemiology, Natural History, Early Diagnosis, and Treatment Options .American Academy of Pain Medicine 1526-2375/08/$15.00/660 660–674 doi:10.1111/j.1526-4637.2007.00347.

[3].     Barrett AM Lucero MA, Le T, Robinson RL, Dworkin RH, Chappell AS, 2007. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007; 8(suppl 2):S50–S62.

[4].     Bener A, Zirie M, Janahi IM, Al-Hamaq AO, Musallam M, Wareham NJ(2009). Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes Res Clin Pract, 2009 Apr; 84(1):99-106. doi: 10.1016/j.diabres.2009.02.003.

[5].     Bonnie Sanders Polin .How to Treat Diabetic Neuropathy. Diabetic Nerve Pain: A Diabetes Complication. http://www.diabeticlifestyle.com/relatedconditions/neuropathy/how-treat-diabetic-neuropathy

http://www.diabeticlifestyle.com/related-conditions/neuropathy/how-treat-diabetic-neuropathy .First published on June 1, 2002.Updated on: May 12, 2016.

[6].     Christopher H Gibbons, Roy Freeman, April 2010 .Treatment induced diabetic neuropathy– a reversible painful autonomic neuropathy. NIH Public Access- Arthur Manuscript. Ann Neurol. 2010 April; 67(4): 534–541. doi:10.1002/ana.21952.

[7].     Davies M, et al. Diabetes Care. 2006; 29: 1518-22. https://public.lillydiabetes.co.uk/diabetes/living-with-diabetes/diabetes

[8].     Daniel WW (1999). Biostatistics: A Foundation for Analysis in the Health Sciences. Seventh edition. New York: John Wiley & Sons.

[9].     Erah* and NA Chuks-Eboka, 2008).Patients’ Perception of the Benefits of Pharmaceutical Care Services in the Management of Hypertension in a Tertiary Health Care Facility in Benin City Pharmacotherapy Group, Faculty of Pharmacy, University of Benin. http://www.tjpr.org.

[10].  Gelman, H. Stern. The Difference Between “Significant” and “Not Significant” is not Itself Statistically Significant. The American Statistician, 60:328–331, 2006.

[11].  Galer BS, et al. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life.2000. https://www.ncbi.nlm.nih.gov/pubmed/10670912

[12].  Gene Shackman, 2001, NYS DOH, Presented at Albany Chapter of American Statistical Association, March 24, 2001 http://faculty.smu.edu/slstokes/stat6380/deff%20doc.pdf.

[13].  Greg Bozimowski, CRNA, MS, 2012. Patient Perceptions of Pain Management Therapy. Pain Manag Nurs. 2012; 13(4):186-193. http://www.medscape.com/viewarticle/774955

[14].  Ingela Wiklund et al. Are treatment benefits in neuropathic pain reflected in the self-assessment of treatment questionnaire? Wiklund et al. Health and Quality of Life Outcomes 2013, 11:8. http://www.hqlo.com/content/11/1/8.

[15].  J. Robinson, Vladimir Skljarevski, a Sandra K; (Duloxetine, Pregabalin, and Duloxetine Plus Gabapentin for Diabetic Peripheral Neuropathic Pain Management in Patients With Inadequate Pain Response to Gabapentin: An Open-Label, Randomized, Noninferiority Comparison. Malcolm.Mayo Clin Proc. 2011 Jul; 86(7): 615–626. PMCID: PMC3127557 .doi: 10.4065/mcp.2010.0681.

[16].  Jaeschke R, Singer J, Guyatt GH, December, 1989. Measurement of health status: ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10:407–15.[PubMed]

[17].  Journal of the American Geriatrics Society (1998; 46:635-651).WebMD Public Information from the U.S. National Institutes of Health Reviewed on September 29, 2006. http://www.webmd.com/pain-management/chronic-pain-conditions?page=2

[18].  Katona C, Peveler R, Dowrick C, et al. Pain symptoms in depression: definition and clinical significance. Clin Med. 2005; 5:390–395. [PMC free article] [PubMed].

[19].  Kristen Jefferies Treatment of Neuropathic Pain Semin. Neurol. 2010; 30(4):425-432. http://www.medscape.com/viewarticle/730671_4

[20].  Lunn MP, Hughes RA, Wiffen PJ, 2014).Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014 Jan 3; ( 1):CD007115. Doi: 10.1002/14651858.CD007115.pub3. Review.

[21].  Mark Davies, Sinead Brophy, Rhys Williams, and Ann Taylor, July 2006.The Prevalence, Severity, and Impact of Painful Diabetic Peripheral.

[22].  Mark Peyrot and Richard R Rubin, June 2011).Perceived medication benefits and their association with interest in using inhaled insulin in type 2 diabetes: a model of patients’ cognitive framework. Doi: 10.2147/PPA.S18799.

[23].  McCracken LM, Gross RT, Dec.1993, Does anxiety affect coping with chronic pain? Clin J Pain. 1993 Dec; 9(4):253-9. PMID: 8118089.

[24].  McKillup, Steve (2006). "Probability helps you make a decision about your results". Statistics Explained: An Introductory Guide for Life Scientists (1st ed). Cambridge, United Kingdom: Cambridge University Press. pp. 44–56. ISBN 0-521-54316-9.

[25].  Milana Votrubec, Ian Thong,2013. Neuropathic pain a management update Volume 42, No.3, March 2013 Pages 92-97. http://www.racgp.org.au/afp/2013/march/neuropathic-pain-update/

[26].  -Minnesota Department of Human Services. Mn Choices. http://www.dhs.state.mn.us/main/groups/county_access/documents/pub/dhs16_180273.pdf .Last update: 06/04/2014.Neuropathy in Type 2 Diabetes. American Diabetes Association. doi.org/10.2337/dc05-2228.

[27].  Mitchell B. Max, Sue A. Lynch,, Joanne Muir, R.N, Susan E. Shoaf,, Bruce Smoller,, Ronald Dubner: Effects of Desipramine, Amitriptyline, and Fluoxetine on Pain in Diabetic Neuropathy N Engl J Med 1992; 326:1250-1256May 7, 1992DOI: 10.1056/NEJM199205073261904.

[28].  Palmer RH. Considerations in defining quality of care. In Palmer RH (ed.). Striving for Quality in Health Care: An Inquiry into Policy and Practice. Ann Arbor: Health Administration .Press 1991:1–59.

[29].  Pam Harrison November 13, 2014: No Clear Winner for Relief of Diabetic Neuropathy Pain- Medscape Medical News. http://www.medscape.com/viewarticle/834877#vp_2

[30].  Qatar Population. Trading and Economics. http://www.tradingeconomics.com/qatar/population-

[31].  Random Choice Generator .www.textfixer.com/tools/random-choice.php

[32].  Rayaz. Malik, Jan.2015, Grand Rounds explores novel diagnostic test for diabetic neuropathy Weill Cornell Medical College in Qatar. http://qatar-weill.cornell.edu/media/reports/2014/diagnostic-test-for-diabetic-neuropathy.html.

[33].  Robert H. Dworkin et al 2007, Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain 132 (2007) 237–251. www.elsevier.com/locate/pain

[34].  Robert J. Tanenberg, Gordon A. IrvingRichard C. Risser; Jonna Ahl, Michael

[35].  Theesen KA, Marsh WR. Relief of diabetic neuropathy with fluoxetine. DICP.1989 Jul-Aug; 23(7-8):572-4. PubMed PMID: 2788334. https://www.ncbi.nlm.nih.gov/pubmed/2788334

[36].  Theresa M. Wizemann and Mary-Lou Pardue, 2001, Does Sex Matter? Committee on Understanding the Biology of Sex and Gender Differences; Board on Health Sciences Policy; Institute of Medicine. DOI: 10.17226/10028.

[37].  Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995; 62:363–372. [PubMed.

[38].  WebMD Medical Reference from Healthwise. Pain Medicines for Diabetic Neuropathy-Topic Overview http://www.webmd.com/diabetes/tc/pain-medicines-for-diabetic-neuropathy-topic-overview last Updated: June 04, 2014.

[39].  William C. Shiel, Jr 2014. Pain (Chronic and Acute) ­ Medicine Net http://www.medicinenet.com/script/main/art.asp?articlekey=40842

[40].  William H. Shrank, Emily R. Cox, Michael A. Fischer, Jyotsna Mehta, and Niteesh K. Choudhry, 2009. Patients’ Perceptions of Generic Medications: doi:10.1377/hlthaff.28.2.546.

[41].  World Health Survey Qatar,2006 http://www.biomedcentral.com/content/supplementary/1478-7954-12-18-S1.pdf