RESEARCH ARTICLE


Screening for Cancer-Related Neuropathic Pain in the Oncology Outpatient Setting in the United Kingdom



Alison Birtle1, *, Susan Davidson2, Gary Atkinson3, Chantal van Litsenburg4
1 Rosemere Cancer Centre, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane North, Preston, UK
2 The Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK
3 Pfizer Ltd, Walton Oaks, UK
4 Pfizer bv, Capelle a/d IJssel, The Netherlands


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Creative Commons License
© 2013 Birtle.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Rosemere Cancer Centre, Royal Preston Hospital, Sharoe Green Lane North, Preston, PR2 9HT, UK; Tel: +44 (0)1772 524762; Fax: +44 (0)1772 522178; E-mail: Alison.Birtle@lthtr.nhs.uk


Abstract

This article reports the outcomes of a sub-analysis of United Kingdom (UK) data collected during a noninterventional, cross-sectional study conducted in five European countries. The primary aim was to estimate the prevalence of cancer-related neuropathic pain (CRNP) in an outpatient sample of adult cancer patients visiting oncology clinics in the UK for standard care. Secondary aims were to report the nature and characteristics of the cancer and the pain in the patients with CRNP. This sub-analysis also assessed the usefulness of the PainDETECT screening tool as an aid for physicians in identifying the neuropathic component of cancer-related pain in daily practice. Based on physicians’ clinical judgment before reviewing the scores on the PainDETECT tool, the estimated number of outpatients with cancer experiencing chronic pain and considered to have CRNP was 104 of 195 patients (53.3%; 95% confidence interval [CI]: 46.3%- 60.3%). After reviewing patients’ scores on the tool, the estimate was 90 of 195 patients (46.2%; 95% CI: 39.2%-53.2%). Physicians changed from a positive (yes) to a negative (no) diagnosis of CRNP for 16 of 127 patients who had a low PainDETECT end score (<13; indicating that neuropathic pain was unlikely). Of the 11 physicians who completed the usefulness of PainDETECT survey, eight indicated that they would use the questionnaire in future for at least some of their patients, although they also indicated that in the majority of cases (63%), the PainDETECT tool did not help them evaluate whether a patient had CRNP. Because of missing data arising from missing or incomplete survey responses, however, these data should be interpreted with caution, and further studies are required to assess the usefulness of this tool.

Keywords: Clinical Oncology, Neuropathic Pain, Outpatients, Questionnaire, PainDETECT.