Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy

Gavin Taylor-Stokes1, James Pike1, Alesia Sadosky2, Arthi Chandran2, Thomas Toelle31Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK; 2Pfizer Inc, New York, NY, USA; 3Department of Neurology, Technische Universit&auml;t M&uuml;nchen, Munich, GermanyObjective:...

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Autores principales:	Taylor-Stokes G, Pike J, Sadosky A, Chandran A, Toelle T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/73c59c1dd03446dca8f482e3855f1d73
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spelling	oai:doaj.org-article:73c59c1dd03446dca8f482e3855f1d732021-12-02T08:42:12ZAssociation of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy1178-7007https://doaj.org/article/73c59c1dd03446dca8f482e3855f1d732011-12-01T00:00:00Zhttp://www.dovepress.com/association-of-patient-rated-severity-with-other-outcomes-in-patients--a8788https://doaj.org/toc/1178-7007Gavin Taylor-Stokes1, James Pike1, Alesia Sadosky2, Arthi Chandran2, Thomas Toelle31Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK; 2Pfizer Inc, New York, NY, USA; 3Department of Neurology, Technische Universit&auml;t M&uuml;nchen, Munich, GermanyObjective: To evaluate the association of patient-reported severity of painful diabetic peripheral neuropathy (pDPN) with other outcomes in a European population of patients using the Adelphi Disease Specific Programme for pDPN (DSP III, 2008).Methods: The severity of patients&#39; pDPN (mild, moderate, or severe) was rated independently by both patients and physicians. Relationships were evaluated between patient-reported pDPN severity and other patient-reported outcomes including pain, sleep, function, and work productivity. Physicians rated the severity of patients&rsquo; pDPN (1 = mild, 2 = moderate, 3 = severe) and sleep interference.Results: Patient-reported data were available from 634 individuals (56.2% male, mean age 63 years) from France, Germany, Italy, and the UK, of whom only 22.2% reported that they were currently employed. pDPN severity was rated as mild, moderate, and severe by 22.2%, 60.9%, and 16.9% of the patients, respectively. There was a significant association between patient-rated and physician-rated pDPN severity (P &lt; 0.0001), although there were discrepancies in agreement (kappa = 0.37, 95% confidence interval [CI] 0.31, 0.43; weighted kappa = 0.43, 95% CI 0.37, 0.48) among physician and patient ratings in a substantial proportion of patients across severity categories. Higher pDPN severity was associated with greater interference of daily function including sleep (P &lt; 0.0001 for all pairwise comparisons). Among employed patients, percent of pDPN-related impairment while at work (presenteeism) and overall work impairment increased with greater pDPN severity, resulting in indirect costs that increased significantly with pDPN severity; $8266, $15,449, and $24,300 for mild, moderate, and severe pDPN, respectively (overall P &lt; 0.001).Conclusion: Severity of patient-rated pDPN was significantly associated with outcomes, including function and productivity; poorer function and lower productivity were reported at higher pDPN severity levels. Moreover, physicians rated pDPN severity different from patients in a substantial proportion of patients.Keywords: diabetic neuropathy, pain, outcomesTaylor-Stokes GPike JSadosky AChandran AToelle TDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 401-408 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Taylor-Stokes G Pike J Sadosky A Chandran A Toelle T Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
description	Gavin Taylor-Stokes1, James Pike1, Alesia Sadosky2, Arthi Chandran2, Thomas Toelle31Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK; 2Pfizer Inc, New York, NY, USA; 3Department of Neurology, Technische Universit&auml;t M&uuml;nchen, Munich, GermanyObjective: To evaluate the association of patient-reported severity of painful diabetic peripheral neuropathy (pDPN) with other outcomes in a European population of patients using the Adelphi Disease Specific Programme for pDPN (DSP III, 2008).Methods: The severity of patients&#39; pDPN (mild, moderate, or severe) was rated independently by both patients and physicians. Relationships were evaluated between patient-reported pDPN severity and other patient-reported outcomes including pain, sleep, function, and work productivity. Physicians rated the severity of patients&rsquo; pDPN (1 = mild, 2 = moderate, 3 = severe) and sleep interference.Results: Patient-reported data were available from 634 individuals (56.2% male, mean age 63 years) from France, Germany, Italy, and the UK, of whom only 22.2% reported that they were currently employed. pDPN severity was rated as mild, moderate, and severe by 22.2%, 60.9%, and 16.9% of the patients, respectively. There was a significant association between patient-rated and physician-rated pDPN severity (P &lt; 0.0001), although there were discrepancies in agreement (kappa = 0.37, 95% confidence interval [CI] 0.31, 0.43; weighted kappa = 0.43, 95% CI 0.37, 0.48) among physician and patient ratings in a substantial proportion of patients across severity categories. Higher pDPN severity was associated with greater interference of daily function including sleep (P &lt; 0.0001 for all pairwise comparisons). Among employed patients, percent of pDPN-related impairment while at work (presenteeism) and overall work impairment increased with greater pDPN severity, resulting in indirect costs that increased significantly with pDPN severity; $8266, $15,449, and $24,300 for mild, moderate, and severe pDPN, respectively (overall P &lt; 0.001).Conclusion: Severity of patient-rated pDPN was significantly associated with outcomes, including function and productivity; poorer function and lower productivity were reported at higher pDPN severity levels. Moreover, physicians rated pDPN severity different from patients in a substantial proportion of patients.Keywords: diabetic neuropathy, pain, outcomes
format	article
author	Taylor-Stokes G Pike J Sadosky A Chandran A Toelle T
author_facet	Taylor-Stokes G Pike J Sadosky A Chandran A Toelle T
author_sort	Taylor-Stokes G
title	Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
title_short	Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
title_full	Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
title_fullStr	Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
title_full_unstemmed	Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
title_sort	association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/73c59c1dd03446dca8f482e3855f1d73
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Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy

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