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12-28-2017 | Neuropathy | Article

Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population

Journal: Clinical Diabetes and Endocrinology

Authors: Martin Eichholz, Andrea H. Alexander, Joseph C. Cappelleri, Patrick Hlavacek, Bruce Parsons, Alesia Sadosky, Michael M. Tuchman

Publisher: BioMed Central

Abstract

Background

Since few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations.

Methods

Kelton fielded a survey by phone or Internet, in English or Spanish, among adults with pDPN symptoms in the United States between August and October 2015; African-Americans and Hispanics were oversampled to achieve at least 500 subjects for each group. Patients were required to have been diagnosed with pDPN or score ≥ 3 on ID Pain validated screening tool. The survey elicited information on pDPN symptoms and interactions with healthcare providers (HCPs), and included the Brief Pain Inventory and pain-specific Work Productivity and Assessment Questionnaire (WPAI:SHP).

Results

Respondents included 823 Caucasians, 525 African-Americans, and 537 Hispanics; approximately half of African-Americans and Hispanics were <40 years of age, vs 12% of Caucasians. Pain was less likely to be rated moderate or severe by African-Americans (65%) and Hispanics (49%) relative to Caucasians (87%; p < 0.05). African-Americans and Hispanics were less likely than Caucasians to report experiencing specific pDPN sensory symptoms. Significantly fewer African-Americans and Hispanics reported receiving a pDPN diagnosis relative to Caucasians (p < 0.05), and higher proportions of African-Americans and Hispanics reported difficulty communicating with their HCP (p < 0.05). WPAI:SHP activity impairment was lower in Hispanics (43%) relative to African-Americans (53%) and Caucasian (56%; p < 0.05).

Conclusions

Multicultural patients reported differences in pDPN symptoms and pain relative to Caucasians, and fewer received a pDPN diagnosis. While further evaluation is needed to understand these differences, these data suggest a need to broaden pDPN educational initiatives to improve patient-HCP dialogue and encourage discussion of pDPN symptoms and their impact in a multicultural setting.
Literature
1.
Sadosky A, McDermott AM, Brandenburg NA, Strauss M. A review of the epidemiology of painful diabetic peripheral neuropathy, post-herpetic neuralgia, and less commonly studied neuropathic pain conditions. Pain Pract. 2008;8(1):45–56.CrossRefPubMed
2.
Jambart S, Ammache Z, Haddad F, Younes A, Hassoun A, Abdalla K, Selwan CA, Sunna N, Wajsbrot D, Youseif E. Prevalence of painful diabetic peripheral neuropathy among patients with diabetes mellitus in the Middle East region. J Int Med Res. 2011;39(2):366–77.CrossRefPubMed
3.
Alleman CJ, Westerhout KY, Hensen M, Chambers C, Stoker M, Long S, van Nooten FE. Humanistic and economic burden of painful diabetic peripheral neuropathy in Europe: a review of the literature. Diabetes Res Clin Pract. 2015;109(2):215–25.CrossRefPubMed
4.
van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654–62.CrossRefPubMed
5.
Stewart WF, Ricci JA, Chee E, Hirsch AG, Brandenburg N. Lost productive time and costs due to diabetes and diabetic neuropathic pain in the US workforce. J Occup Environ Med. 2007;49(6):672–9.CrossRefPubMed
6.
daCosta DiBonaventura M, Cappelleri JC, Joshi AV. A longitudinal assessment of painful diabetic peripheral neuropathy on health status, productivity, and health care utilization and cost. Pain Med. 2011;12(1):118–26.CrossRefPubMed
7.
Sadosky A, Mardekian J, Parsons B, Hopps M, Bienen EJ, Markman J. Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy. J Diabetes Complicat. 2015;29(2):212–7.CrossRefPubMed
8.
Sadosky A, Hopper J, Parsons B. Painful diabetic peripheral neuropathy: results of a survey characterizing the perspectives and misperceptions of patients and healthcare practitioners. Patient. 2014;7(1):107–14.CrossRefPubMed
9.
Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID pain. Curr Med Res Opin. 2006;22(8):1555–65.CrossRefPubMed
10.
Cleeland CS, Ryan KM. Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap. 1994;23(2):129–38.PubMed
11.
Work Productivity and Activity Impairment Questionnaire: Specific Health Problem V2.0 (WPAI:SHP) [http://​www.​reillyassociates​.​net/​WPAI_​SHP.​html].
12.
Zelman D, Dukes E, Brandenburg N, Bostrom A, Gore M. Identification of cut-points for mild, moderate and severe pain due to diabetic peripheral neuropathy. Pain. 2005;115(2):29–36.CrossRefPubMed
13.
Kleinbaum DG, Kupper LL, Nizam A, Rosenberg ES. Applied regression analysis and other multivariate methods. 5th ed. Boston: Cengage Learning; 2014.
14.
Rahim-Williams B, Riley JL 3rd, Williams AK, Fillingim RB. A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter? Pain Med. 2012;13(4):522–40.CrossRefPubMedPubMedCentral
15.
Hollingshead NA, Ashburn-Nardo L, Stewart JC, Hirsh AT. The pain experience of Hispanic Americans: a critical literature review and conceptual model. J Pain. 2016;17(5):513–28.CrossRefPubMedPubMedCentral
16.
Kim H, Neubert JK, San Miguel A, Xu K, Krishnaraju RK, Iadarola MJ, Goldman D, Dionne RA. Genetic influence on variability in human acute experimental pain sensitivity associated with gender, ethnicity and psychological temperament. Pain. 2004;109(3):488–96.CrossRefPubMed
17.
Campbell CM, Edwards RR. Ethnic differences in pain and pain management. Pain Manag. 2012;2(3):219–30.CrossRefPubMedPubMedCentral
18.
National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta: U.S. Department of Health and Human Services. http://​www.​thefdha.​org/​pdf/​diabetes.​pdf.
19.
National Healthcare Disparities Report, 2013. Publication # 14–0006 [http://​www.​ahrq.​gov/​research/​findings/​nhqrdr/​nhdr13/​2013nhdr.​pdf].
20.
Betancourt JR, Corbett J, Bondaryk MR. Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation. Chest. 2014;145(1):143–8.CrossRefPubMed

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