Open AccessEffective Pharmacological Treatment of Painful Diabetic Neuropathy by Nurse Practitioners: Results of an Algorithm‐Based Experience
Author(s) -
Geerts Margot,
LandewéCleuren Sabine A. N. T.,
Kars Marleen,
Vrijhoef Hubertus J. M.,
Schaper Nicolaas C.
Publication year - 2012
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2012.01469.x
Subject(s) - medicine , diabetic neuropathy , quality of life (healthcare) , patient satisfaction , diabetes mellitus , physical therapy , outpatient clinic , nursing , intensive care medicine , endocrinology
Objective. To improve the care of patients with painful diabetic polyneuropathy (PDP) by a specialized outpatient clinic for individuals referred by general practitioners and to determine the effects on pain, quality of life, and patient satisfaction. Material and Methods. One hundred twenty‐one patients were prospectively enrolled. At baseline and after 12 months at end of treatment, patients filled in a set of validated questionnaires on severity and interference of pain, quality of life, anxiety and depression, and patient satisfaction with the service offered. Setting. The outpatient clinic is part of a regional chronic care management program, which includes both hospital‐based endocrinologists and general practitioners. Results. Twenty‐eight patients (27%) did not need any further treatment after one visit to the outpatient clinic. As initial drug, pregabalin was the most commonly prescribed drug (65%); amitriptyline was prescribed in only 30% due to its contraindications. Improvements were found in all pain scores ( P < 0.05). Pain interference was improved in sleep ( P < 0.01), general activity, and mood ( P < 0.05). More than half of the patients (65%) were satisfied with the treatment and whished no further medication changes; 52% had a treatment success defined as pain relief ≥ 30%. Medication was stopped due to inefficacy in 9% of patients and changed due to adverse effects in 20% of the patients. Conclusions. A specialized outpatient clinic for patients with PDP is an effective health care service. Using diagnostic instruments and a defined treatment algorithm, significant pain reduction was achieved in the majority of patients in a relative short period of time.