Neuropathic Pain Management in France: A Comparison of French Recommendations Using Case-Vignette Surveys.

IF 2.6 2区 医学 Q2 ANESTHESIOLOGY
Pain physician Pub Date : 2025-03-01
Paul Elhomsy, Stephane Sanchez, Catherine Doussot, Philippe Rault
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引用次数: 0

Abstract

Background: Despite the availability of clinical practice guidelines, suboptimal adherence among general practitioners (GPs) in pain management remains a concern. The French Pain Society issued revised guidelines for pain management in 2020.

Objectives: This study aimed to evaluate the current adherence of French doctors to the updated guidelines for pain management.

Study design: A non-interventional, cross-sectional study.

Setting:   A panel of doctors from France, participated in an online questionnaire.

Methods: Two selected vignettes describing patients with chronic neuropathic pain (central and peripheral) were completed. The ability to correctly prescribe appropriate first- and second-line treatments according to the 2020 French Pain Society guidelines was assessed.

Results: A total of 191 physicians were recruited from a database of 3,380, representing a response rate of 5.7%. Of the participants, 182 (95.3%) completed the survey correctly and were included in the final analysis. Among those participants, 64% were general practitioners (GPs). Adherence to the guidelines for the management of l ocalized peripheral neuropathic pain was reported by 15.38% of participants, while 21% reported adherence for central neuropathic pain. A significant disparity was observed in the prescription of medications, with pregabalin being prescribed by 32.9% of participants and gabapentin by 22.5% for localized neuropathic pain. For central neuropathic pain, pregabalin use was reported by 30.7% of respondents and gabapentin by 26.3%. Following the failure of a second-line therapy, 66% of participants considered reorientation to be a viable treatment option for localized peripheral neuropathic pain, compared to 45% for central neuropathic pain.

Limitations: The number of participants is one of the main limitations in this study.

Conclusions: Despite the participants' low adherence to guidelines, substantial variation in medication use, and limited support for reorientation after failed treatment, this study offers insight into management practices for neuropathic pain among French GPs in Burgundy.

神经性疼痛管理在法国:比较法国的建议使用个案调查。
背景:尽管有临床实践指南,但全科医生(GPs)在疼痛治疗中的遵守情况不佳仍是一个令人担忧的问题。法国疼痛学会于 2020 年发布了疼痛治疗指南修订版:本研究旨在评估法国医生目前对最新疼痛治疗指南的遵守情况:研究设计:非干预性横断面研究: 法国医生小组参与了在线问卷调查:方法:选取两个描述慢性神经病理性疼痛(中枢性和外周性)患者的小故事进行填写。根据2020年法国疼痛学会指南,评估医生正确开具适当的一线和二线治疗处方的能力:从 3380 名医生的数据库中招募了 191 名医生,回复率为 5.7%。其中 182 人(95.3%)正确填写了调查问卷,并被纳入最终分析。在这些参与者中,64%是全科医生(GP)。15.38%的参与者表示遵守了外周神经病理性疼痛治疗指南,21%的参与者表示遵守了中枢神经病理性疼痛治疗指南。在处方用药方面观察到了明显的差异,32.9% 的参与者处方了普瑞巴林,22.5% 的参与者处方了加巴喷丁治疗局部神经病理性疼痛。对于中枢性神经病理性疼痛,30.7% 的受访者使用普瑞巴林,26.3% 的受访者使用加巴喷丁。在二线疗法失败后,66%的参与者认为重新定向是治疗局部外周神经病理性疼痛的可行方案,而中枢神经病理性疼痛的这一比例为45%:参与者人数是本研究的主要局限之一:尽管参与者对指南的依从性较低、药物使用存在很大差异、对治疗失败后重新定位的支持有限,但本研究为勃艮第地区的法国全科医生了解神经病理性疼痛的管理实践提供了参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pain physician
Pain physician CLINICAL NEUROLOGY-CLINICAL NEUROLOGY
CiteScore
6.00
自引率
21.60%
发文量
234
期刊介绍: Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year. Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.
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