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

Authors

  • Esther G. P. van Kollenburg MD,

    Corresponding author
    • Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Vijmegen Medical Centre, Nijmegen, the Netherlands
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  • Jan C. M. Lavrijsen MD, PhD,

    1. Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Vijmegen Medical Centre, Nijmegen, the Netherlands
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  • Stans C. Verhagen MD, PhD,

    1. Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Sytse U. Zuidema MD, PhD,

    1. Department of General Practice, Groningen, University of Groningen, University Medical Centre, Groningen, the Netherlands
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  • Annelies Schalkwijk MSc,

    1. Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Kris C. P. Vissers MD, Phd, FIPP

    1. Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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Address correspondence to Esther G. P. van Kollenburg, Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, PO Box 9101, 117 ELG, 6500 HB Nijmegen, the Netherlands. E-mail: e.vankollenburg@elg.umcn.nl

Abstract

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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