Rifky Alif Novianto, Hanik Badriyah Hidayati, Hermina Novida, Klára Bodová

Retrospective Analysis of Numerical Pain Rating Scale (NPRS) Scores in Diabetic Neuropathy Patients Receiving Gabapentin and Non-Gabapentin Therapies at an Indonesian Tertiary Hospital

Introduction

Retrospective analysis of numerical pain rating scale (nprs) scores in diabetic neuropathy patients receiving gabapentin and non-gabapentin therapies at an indonesian tertiary hospital. Retrospective analysis of DNP patients at an Indonesian hospital found gabapentin monotherapy effectively reduced Numerical Pain Rating Scale (NPRS) scores over 4-12 weeks.

Abstract

Introduction: Diabetic neuropathy is a common complication of diabetes, affecting over half of patients and frequently leading to diabetic neuropathic pain (DNP), which can be difficult to treat. Gabapentin is commonly used as a first-line therapy for DNP and works by modifying calcium channels to reduce pain. This study aimed to evaluate and compare Numerical Pain Rating Scale (NPRS) profiles in DNP patients receiving gabapentin and non-gabapentin therapies at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Methods: This retrospective study analyzed the medical records of 24 DNP patients at Dr. Soetomo General Academic Hospital from January to December 2023. The inclusion criteria comprised patients diagnosed with diabetic neuropathy, according to the International Statistical Classification of Diseases, Tenth Revision (ICD-10) code E11.4, and treated for pain using gabapentin and/or other therapies. Patients with incomplete records or unrelated neuropathic conditions were excluded. The data encompassed NPRS scores, demographics, diabetes mellitus duration, pain characteristics, drug types, doses, and therapy durations. Results: Among 24 patients, the majority were female (54.1%) and over 60 years old (58.3%), with a diabetes duration of 6–10 years (54.1%). Tingling was the most frequently observed symptom (75%). Gabapentin administered as monotherapy (1×300 mg) was the predominant treatment (56.5%) and provided the greatest reduction in NPRS scores (7 points) after 4–12 weeks. Combination therapies showed smaller reductions. Conclusion: Gabapentin used as monotherapy is effective for managing DNP, especially over 4–12 weeks. Patients with long-standing diabetes, particularly older adults, are the most affected and benefit from targeted therapy. Highlights: 1. This study evaluates the demographic, clinical, and therapeutic profiles of patients with diabetic neuropathic pain, focusing on gabapentin and non-gabapentin therapies.2. Novel insights into the distribution of therapies and numerical pain rating scale (NPRS) scores among patients offer a foundation for optimizing pain management strategies.3. This research contributes to identifying patterns in drug efficacy and therapy duration, particularly with the administration of gabapentin for managing diabetic neuropathic pain.

Review

This retrospective analysis investigates the effectiveness of gabapentin and non-gabapentin therapies in managing diabetic neuropathic pain (DNP) among patients at an Indonesian tertiary hospital, using Numerical Pain Rating Scale (NPRS) scores. The study addresses a clinically relevant issue, as DNP is a significant complication of diabetes that often proves challenging to treat. By focusing on a specific patient population within Indonesia, the research provides valuable real-world data from a context that may differ in treatment patterns and patient characteristics from Western populations, contributing to a more globally representative understanding of DNP management. The use of NPRS scores as a primary outcome measure is appropriate and standard for assessing pain intensity. The methodology, though limited by its retrospective nature and a modest sample size of 24 patients, provides initial insights into therapeutic practices and outcomes. The demographic profile aligns with general expectations for DNP, with older adults and those with long-standing diabetes being most affected, and tingling as a prevalent symptom. The key finding that gabapentin administered as monotherapy (1x300mg) demonstrated the most substantial reduction in NPRS scores (7 points) over 4-12 weeks, surpassing combination therapies, is noteworthy. This suggests a potential therapeutic preference for monotherapy in this patient cohort and provides an empirical basis for optimizing pain management strategies, particularly within the specific clinical setting studied. While offering valuable preliminary data, the study's limitations necessitate careful interpretation of its conclusions. The small sample size and single-center retrospective design limit the generalizability of the findings and preclude definitive causal inferences or robust comparative analyses between specific therapeutic regimens. The abstract mentions "non-gabapentin therapies" but lacks detail on their specific types and doses, making it difficult to fully assess the comparative efficacy. Future research should build upon these initial observations by conducting larger, prospective, multi-center studies with detailed characterization of all treatment arms, including specific non-gabapentin agents and their dosing regimens. Such studies would further elucidate optimal DNP management strategies and potentially inform evidence-based guidelines tailored for diverse patient populations.

Full Text

Comments

You need to be logged in to post a comment.