Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina
Jimmy Pruitt III,1 Carolina Moracho-Vilrriales,1,2 Tiffaney Threatt,3 Sarah Wagner,3 Jun Wu,1 E Alfonso Romero-Sandoval1 1Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA; 2Department of Biochemistry and Biotechnology, University of...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-04-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-peer-reviewed-article-JPR |
| _version_ | 1819230452126318592 |
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| author | Pruitt III J Moracho-Vilrriales C Threatt T Wagner S Wu J Romero-Sandoval EA |
| author_facet | Pruitt III J Moracho-Vilrriales C Threatt T Wagner S Wu J Romero-Sandoval EA |
| author_sort | Pruitt III J |
| collection | DOAJ |
| description | Jimmy Pruitt III,1 Carolina Moracho-Vilrriales,1,2 Tiffaney Threatt,3 Sarah Wagner,3 Jun Wu,1 E Alfonso Romero-Sandoval1 1Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA; 2Department of Biochemistry and Biotechnology, University of Alcalá de Henares, Madrid, Spain; 3Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC, USA Abstract: Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen. We performed a retrospective analysis of clinical records of patients from the Presbyterian College School of Pharmacy (PCSP) Wellness Center located in Clinton, SC. Diagnoses of DPN and/or p-DN were obtained from referral notes in the clinical records and compared with results from foot examinations performed in the free clinic and clinical features. Medication regimens were also obtained and compared using American Academy of Neurology (AAN) treatment guidelines. Within our study population (n=111), the prevalence of DPN was 62.2% (national average of 28%–45%) and that of p-DN was 23.4% (national average of 11%–24%). In p-DN patients (n=26), 53.8% (n=14) had a documented diagnosis of p-DN by the referring physician, and 46.2% (n=12) were identified by the pharmacists. A total of 95% (19 of 20) of the patients treated for p-DN received adequate pharmacological agents, though suboptimal as per clinical guidelines. More than 50% of the patients used subtherapeutic doses of their medications. Gabapentin was the most frequently used medication in our population (65.4%). Patients in rural South Carolina had a higher prevalence of DPN and p-DN with >60% undocumented cases of p-DN. More than 95% of treated patients did not receive optimum therapy according to AAN guidelines. Keywords: polysensory neuropathy, pharmacist-led diabetes clinic, diabetes educator, gabapentin, chronic pain free clinic, pain, gabapentin |
| first_indexed | 2024-12-23T11:29:17Z |
| format | Article |
| id | doaj.art-0916b8d3f9ae42588bf4936046223ce1 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-23T11:29:17Z |
| publishDate | 2017-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-0916b8d3f9ae42588bf4936046223ce12022-12-21T17:48:50ZengDove Medical PressJournal of Pain Research1178-70902017-04-01Volume 1083384332279Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South CarolinaPruitt III JMoracho-Vilrriales CThreatt TWagner SWu JRomero-Sandoval EAJimmy Pruitt III,1 Carolina Moracho-Vilrriales,1,2 Tiffaney Threatt,3 Sarah Wagner,3 Jun Wu,1 E Alfonso Romero-Sandoval1 1Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA; 2Department of Biochemistry and Biotechnology, University of Alcalá de Henares, Madrid, Spain; 3Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC, USA Abstract: Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen. We performed a retrospective analysis of clinical records of patients from the Presbyterian College School of Pharmacy (PCSP) Wellness Center located in Clinton, SC. Diagnoses of DPN and/or p-DN were obtained from referral notes in the clinical records and compared with results from foot examinations performed in the free clinic and clinical features. Medication regimens were also obtained and compared using American Academy of Neurology (AAN) treatment guidelines. Within our study population (n=111), the prevalence of DPN was 62.2% (national average of 28%–45%) and that of p-DN was 23.4% (national average of 11%–24%). In p-DN patients (n=26), 53.8% (n=14) had a documented diagnosis of p-DN by the referring physician, and 46.2% (n=12) were identified by the pharmacists. A total of 95% (19 of 20) of the patients treated for p-DN received adequate pharmacological agents, though suboptimal as per clinical guidelines. More than 50% of the patients used subtherapeutic doses of their medications. Gabapentin was the most frequently used medication in our population (65.4%). Patients in rural South Carolina had a higher prevalence of DPN and p-DN with >60% undocumented cases of p-DN. More than 95% of treated patients did not receive optimum therapy according to AAN guidelines. Keywords: polysensory neuropathy, pharmacist-led diabetes clinic, diabetes educator, gabapentin, chronic pain free clinic, pain, gabapentinhttps://www.dovepress.com/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-peer-reviewed-article-JPRpainfuldiabetic neuropathyruralfree clinicpaingabapentin. |
| spellingShingle | Pruitt III J Moracho-Vilrriales C Threatt T Wagner S Wu J Romero-Sandoval EA Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina Journal of Pain Research painful diabetic neuropathy rural free clinic pain gabapentin. |
| title | Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina |
| title_full | Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina |
| title_fullStr | Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina |
| title_full_unstemmed | Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina |
| title_short | Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina |
| title_sort | identification prevalence and treatment of painful diabetic neuropathy in patients from a rural area in south carolina |
| topic | painful diabetic neuropathy rural free clinic pain gabapentin. |
| url | https://www.dovepress.com/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-peer-reviewed-article-JPR |
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