Prevalence, causes, and treatment of neuropathic pain in dutch nursing home residents: a retrospective chart review.
SourceJournal of the American Geriatrics Society, 60, 8, (2012), pp. 1418-1425
1 augustus 2012
Article / Letter to editor
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Primary and Community Care
Journal of the American Geriatrics Society
SubjectNCEBP 11: Alzheimer Centre; NCEBP 7: Effective primary care and public health; NCEBP 7: Effective primary care and public health ONCOL 2: Age-related aspects of cancer; ONCOL 4: Quality of Care; DCN MP - Plasticity and memory NCEBP 7: Effective primary care and public health
OBJECTIVES: To identify the prevalence and causes of neuropathic pain in Dutch nursing home residents; to establish the prevalence of painful and nonpainful diabetic polyneuropathy in a subsample of individuals with diabetes mellitus and central poststroke pain (CPSP) in a subsample of individuals who had a stroke; and to study the prescription of antineuropathic drugs. DESIGN: A descriptive, retrospective, cross-sectional study conducted by analyzing medical records. SETTING: Data were collected in 12 Dutch nursing homes. PARTICIPANTS: The data were derived from the medical records of 497 residents of chronic long-term stay and rehabilitation nursing home units. MEASUREMENTS: Four groups were defined: actual (at some time in the previous year) neuropathic pain (ANP), possible neuropathic pain (PNP), neuropathic pain in the past (NPP), and no signs of neuropathic pain (NoNP). RESULTS: The prevalence of ANP was 10.9% (95% confidence interval (CI) = 8.4-13.8%) and of PNP was 5.6% (95% CI = 3.9-7.9%). The most common causes were CPSP and phantom limb pain. In the subgroup with diabetes mellitus, 6.3% had nonpainful diabetic polyneuropathy, 0.7% had painful diabetic polyneuropathy, and 0.7% had possible painful diabetic polyneuropathy. In the poststroke subsample, 4.7% were identified as having CPSP, and 5.2% were identified as possibly having CPSP. Within the ANP group, 68.5% of the residents received antineuropathic drugs on the day the medical records were examined; 48.1% used anticonvulsants. CONCLUSION: Dutch nursing home residents frequently experience neuropathic pain; therefore, neuropathic pain should receive more attention in frail elderly adults.
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