Prevalence, Causes, and Treatment of Neuropathic Pain in Dutch Nursing Home Residents: A Retrospective Chart Review

• Published in: Journal of the American Geriatrics Society (JAGS) 2012-08, Vol.60 (8), p.1418-1425
• Main Authors: van Kollenburg, Esther G. P., Lavrijsen, Jan C. M., Verhagen, Stans C., Zuidema, Sytse U., Schalkwijk, Annelies, Vissers, Kris C. P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Cross-Sectional Studies; Female; frail elderly; General aspects; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Nervous system (semeiology, syndromes); Netherlands; Neuralgia - epidemiology; Neuralgia - etiology; Neuralgia - therapy; Neurological disorders; Neurology; neuropathic pain; Nursing Homes; Pain management; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2012.04078.x

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.