Towards a definition of refractory neuropathic pain for epidemiological research. An international Delphi survey of experts

Smith, B.H., Torrance, N., Ferguson, J.A., Bennett, M.I., Serpell, M.G. and Dunn, K.M. (2012) Towards a definition of refractory neuropathic pain for epidemiological research. An international Delphi survey of experts. BMC Neurology, 12(1), p. 29. (doi: 10.1186/1471-2377-12-29)

Abstract

<p>Background: Best current estimates of neuropathic pain (NeuP) prevalence come from studies using various screening detecting pain with probable neuropathic features; the proportion experiencing significant, long-term NeuP, and the proportion not responding to standard treatment are unknown. These “refractory” cases are the most clinically important to detect, being the most severe, requiring specialist treatment.</p> <p>Methods: We report an international Delphi survey of experts in NeuP, aiming for consensus on the features required to define, for epidemiological research: (1) neuropathic pain; and (2) when NeuP is “refractory”. A webbased questionnaire was developed and data collected from three rounds of questionnaires from nineteen experts.</p> <p>Results: There was good consensus on essential inclusion of six items to identify NeuP (“prickling, tingling, pins and needles”, “pain evoked by light touch”, “electric shocks or shooting pain”, “hot or burning” pain, “brush allodynia on self-examination”, and “relevant history”) and on some items that were non-essential. Consensus was also reached on components of a “refractory NeuP” definition: minimum duration (one year); number of trials of drugs of known effectiveness (four); adequate duration of these trials (three months / maximum tolerated); outcomes of treatment(pain severity, quality of life). Further work needs to validate these proposed criteria in general population research.</p> <p>Conclusions: This paper presents an international consensus on measuring the epidemiology of refractory neuropathic pain. This will be valuable in reaching an agreed estimate of the prevalence of neuropathic pain, and the first estimate of refractory neuropathic pain prevalence.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Serpell, Dr Michael and Smith, Prof Blair
• Authors: Smith, B.H., Torrance, N., Ferguson, J.A., Bennett, M.I., Serpell, M.G., and Dunn, K.M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMC Neurology
• Publisher: BioMed Central Ltd
• ISSN: 1471-2377
• Published Online: 28 May 2012
• Copyright Holders: Copyright © 2012 The Authors
• First Published: First published in BMC Neurology 12(1):29
• Publisher Policy: Reproduced under a Creative Commons License