Impact of pain severity on each EQ-5D-5L dimension of quality of life in patients with neuropathic pain associated with chronic low back or cervical pain: an ad hoc analysis.

Abstract

Objectives: Clinical guidelines for patients with neuropathic pain (NeP) recommend setting achievable treatment goals relevant to their daily lives. We therefore evaluated the associations of the EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) with reduced quality of life (QoL) in patients with chronic low back pain with NeP (CLBP-NeP) or chronic cervical pain with NeP (CCP-NeP) to help inform the setting of such treatment goals.

Methods: Secondary data were analyzed from two observational studies of patients with CLBP-NeP or CCP-NeP. The associations of each EQ-5D-5L dimension (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) with reduced QoL (defined as the ratio of each dimension to the increase in disutility) of patients with CLBP-NeP or CCP-NeP by change in pain Numeric Rating Scale (NRS) were calculated.

Results: In patients with CLBP-NeP, mobility and pain/discomfort were associated with reduced QoL at lower pain levels, which was maintained at higher pain levels for mobility, but not for pain/discomfort. Anxiety/depression and self-care were associated with reduced QoL at higher pain levels. Usual activity was associated with reduced QoL across pain levels. In patients with CCP-NeP, an association of pain/discomfort with reduced QoL was observed across pain levels, increasing at higher pain levels. Usual activity was associated with reduced QoL at lower pain levels, with this association decreasing at higher levels. Self-care was associated with reduced QoL across pain levels, and mobility was more strongly associated at higher levels. Anxiety/depression was associated with reduced QoL across pain levels.

Conclusions: These results indicate that factors associated with reduced QoL in patients with CLBP-NeP or CCP-NeP may differ depending on pain level. Focusing on mobility at lower pain levels and on psychological aspects at higher levels in CLBP-NeP, and on usual activities and pain/discomfort in CCP-NeP, may help set more effective treatment goals. An individualized approach may also help to improve patients' QoL of patients with NeP.