Neuropathic pain in a primary care electronic health record database

Background Neuropathic pain ( NP ) is common in the adult population but is difficult to study in electronic health record ( EHR ) databases because it is a symptom rather than a pathologic diagnosis. The first step in studying NP in EHR databases is to develop methods for identifying patients with NP . The objectives of this study were to develop estimates of the prevalence of NP among patients in a primary care EHR database and describe these patients’ demographic characteristics and health‐care utilization. Methods This was a retrospective cohort study of de‐identified data from a 5‐year period (2005–2010) from 23 general practitioners ( GPs ) in 10 primary care practices in southwestern O ntario, C anada. International Classification of Diseases version 9 ( ICD ‐9) diagnostic codes and medication prescriptions were used to identify patients with certain and probable NP . Results Different methods produced prevalence estimates ranging from 1.5% (for certain NP in the epidemiologically rigorous period cohort) to 11.2% (for certain NP  + probable NP in the more inclusive database cohort). Patients in the NP groups had more GP visits, specialist referrals and analgesic prescriptions than patients without NP . Conclusion This study represents a step towards being able to utilize EHR databases to study NP by proposing methods to identify patients with certain and probable NP in a primary care EHR database. Validation against a gold standard is the next step.