Cross-sectional study of patient satisfaction with oral analgesics in patients with chronic pain in Japan

Figures & data

Table 1. NeP screening questionnaire [11,12].

How would you describe your pain? Please choose one for each question.
1. Stinging pain
□ Never	□Slightly	□ Moderately	□ Strongly	□ Very strongly
2. Electric like pain
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly
3. Burning pain
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly
4. Numbness
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly
5. Pain induced by mild stimulations such as clothing touching the skin or cold wind
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly
6. Hypoesthesia or hyperesthesia in the painful area
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly
7. Swelling or skin color change (red or purple) in the painful area
□ Never	□ Slightly	□ Moderately	□ Strongly	□ Very strongly

Cited from the Guidelines for the Pharmacologic Management of Neuropathic Pain [12] under permission from Japan Society of Pain Clinicians. This questionnaire was modified from the original questionnaire reported by Ogawa [11].

Table 2. Evaluation of patient satisfaction, pain relief, ADL improvement, and doctor–patient communication.

1. Patient satisfaction

Question: Do you feel satisfied with this drug? (Patient satisfaction was assessed on the following 5-point scale)

(1) Unsatisfied

(2) Unsatisfied if anything

(3) Neither satisfied nor unsatisfied

(4) Satisfied if anything

(5) Satisfied

2. Pain relief

Question: Has your pain improved with this drug? (Pain relief was assessed on the following 4-point scale)

(1) Unchanged

(2) Slightly improved

(3) Substantially improved

(4) Completely improved

3. ADL improvement

Question: Did this drug improve your ADL restricted by pain? (ADL improvement was assessed on the following 5-point scale)

(1) Not improved

(2) Slightly improved

(3) Substantially improved

(4) Mostly improved

(5) Completely improved

4. Doctor–patient communication

Question: How much can you communicate with your doctor about your pain? (The degree of doctor-patient communication regarding pain was assessed on the following 5-point scale)

(1) Not communicated

(2) Not communicated if anything

(3) Neither communicated nor not communicated

(4) Communicated if anything

(5) Communicated

ADL, activity of daily living.

Figure 1. Patient disposition.

Table 3. Patient characteristics.

Parameter	Category	NSAID group	NeP drug group	Total
Total number of patients		393	388	781
Gender, n (%)	Male	125 (31.8)	165 (42.5)	290 (37.1)
	Female	268 (68.2)	223 (57.5)	491 (62.9)
Age	Number of patients	393	388	781
	Mean (standard deviation) (years)	68.4 (13.2)	71.9 (12.3)	70.1 (12.9)
	Median (min, max) (years)	70.0 (29, 93)	74.0 (21, 98)	72.0 (21, 98)
	20–29 years, n (%)	1 (0.3)	3 (0.8)	4 (0.5)
	30–39 years	9 (2.3)	4 (1.0)	13 (1.7)
	40–49 years	32 (8.1)	14 (3.6)	46 (5.9)
	50–59 years	46 (11.7)	34 (8.8)	80 (10.2)
	60–69 years	100 (25.4)	79 (20.4)	179 (22.9)
	70–79 years	121 (30.8)	134 (34.5)	255 (32.7)
	≥80 years	84 (21.4)	120 (30.9)	204 (26.1)
	<65 years	131 (33.3)	83 (21.4)	214 (27.4)
	≥65 to <75 years	114 (29.0)	120 (30.9)	234 (30.0)
	≥75 years	148 (37.7)	185 (47.7)	333 (42.6)
Clinical department treated at n (%)	Orthopedic Surgery	165 (42.0)	193 (49.7)	358 (45.8)
	Internal medicine	156 (39.7)	92 (23.7)	248 (31.8)
	Surgery	16 (4.1)	17 (4.4)	33 (4.2)
	Psychosomatic medicine/psychiatry	14 (3.6)	2 (0.5)	16 (2.0)
	Neurosurgery and neurology	10 (2.5)	34 (8.8)	44 (5.6)
	Dermatology	3 (0.8)	8 (2.1)	11 (1.4)
	Anesthesiology/pain clinic	2 (0.5)	17 (4.4)	19 (2.4)
	Other	27 (6.9)	25 (6.4)	52 (6.7)
NeP screening score	Number of patients	360	364	724
	Mean (standard deviation), score	5.3 (4.76)	6.8 (5.26)	6.0 (5.06)
NRS	Number of patients	379	368	747
	Mean (standard deviation), score	4.0 (2.49)	4.0 (2.51)	4.0 (2.5)

n, number of patients; NSAID, nonsteroidal anti-inflammatory drug; NeP, neuropathic pain; NRS, numerical rating scale.

Table 4. Number and proportion of patients by drugs and daily prescription doses.

			Daily prescription dose (mg or unit/day)
Drug group	Generic name	Number of patients (%)	Mean	Median	Approved dose
NSAIDs	Loxoprofen	176 (44.8)	111.6 mg	120.0 mg	180 mg
(n = 393)	Celecoxib	157 (39.9)	199.4 mg	200.0 mg	200 mg
	Diclofenac	14 (3.6)	54.5 mg	50.0 mg	75–150 mg
	Meloxicam	14 (3.6)	10.4 mg	10.0 mg	10 mg
NeP drugs	Pregabalin	259 (66.8)	101.4 mg	75.0 mg	300 mg
(n = 388)	Duloxetine	59 (15.2)	33.8 mg	20.0 mg	40 or 60 mg^a
	Neurotropin	40 (10.3)	13.0 units	16.0 units	16 units

^a40 mg: diabetic peripheral neuropathy, 60 mg: chronic low back pain, osteoarthritis, and fibromyalgia.

n, number of patients; NSAID, nonsteroidal anti-inflammatory drug; NeP, neuropathic pain.

Figure 2. Patient satisfaction with NSAIDs and NeP drugs in all the patients.

Figure 3. Patient satisfaction with analgesics in the NeP and non-NeP patient groups.

Table 5. Patient satisfaction with NSAIDs and NeP drugs in the NeP or non-NeP patient groups.

Patient groups		NSAID group	NeP drug group
Total number of patients		360	364
NeP patient group (≥9 points^a)	Total number of patients	82 (42.5%)	111 (57.5%)
	Numbers of patients who answered ‘satisfied if anything’ or better	57 (69.5%)	68 (61.3%)
	95% CI^b	58.4, 79.2	51.5, 70.4
Non-NeP patient group (≤8 points^a)	Total number of patients	278 (52.4%)	253 (47.6%)
	Numbers of patients who answered ‘satisfied if anything’ or better	203 (73.0%)	173 (68.4%)
	95% CI^b	67.4, 78.1	62.3, 74.1

^aNeP screening score.

^bExact two-sided 95% confidence interval (CI) was calculated using Clopper–Pearson method for each drug group.

NSAID, nonsteroidal anti-inflammatory drug; NeP, neuropathic pain.

Figure 4. Pain relief, ADL improvement, and doctor–patient communication with analgesic therapy.

Figure 5. Doctor–patient communication of analgesics in the NeP patient and non-NeP patient groups.

Ogawa S. Development of new screening questionnaire to identify neuropathic components in Japanese patients with chronic pain. Pain Clinic. 2010;31:1187–1194. Japanese.

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Japan Society of Pain Clinicians, eds. Guidelines for the pharmacologic management of neuropathic pain. 2nd ed. Tokyo, Japan: Shinko Trading Co., Ltd.; 2016. [cited 2019 Oct 10]. Japanese/English (Japanese Guideline, p34, Figure 2/English Guideline, p156, Figure 2). Available from: http://minds4.jcqhc.or.jp/minds/Pharmacologic-management-of-neuropathic-pain/Pharmacologic-management-of-neuropathic-pain.pdf

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