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Abstract Background Neuropathic pain (NeP) is a common symptom of a group of a variety of conditions, including diabetic neuropathy, trigeminal neuralgia, or postherpetic neuralgia. Prevalence of NeP has been estimated to range between 5-7.5%, and produces up to 25% of pain clinics consultations. Due to its severity, chronic evolution, and associated co-morbidities, NeP has an important individual and social impact. The objective was to analyze the effect of pregabalin (PGB) on pain alleviation and longitudinal health and non-health resources utilization and derived costs in peripheral refractory NeP in routine medical practice in primary care settings (PCS) in Spain. Methods Subjects from PCS were older than 18 years, with peripheral NeP (diabetic neuropathy, post-herpetic neuralgia or trigeminal neuralgia), refractory to at least one previous analgesic, and included in a prospective, real world, and 12-week two-visit cost-of-illness study. Measurement of resources utilization included both direct healthcare and indirect expenditures. Pain severity was measured by the Short Form-McGill Pain Questionnaire (SF-MPQ). Results One-thousand-three-hundred-fifty-four PGB-naive patients [58.8% women, 59.5 (12.7) years old] were found eligible for this secondary analysis: 598 (44%) switched from previous therapy to PGB given in monotherapy (PGBm), 589 (44%) received PGB as add-on therapy (PGB add-on), and 167 (12%) patients changed previous treatments to others different than PGB (non-PGB). Reductions of pain severity were higher in both PGBm and PGB add-on groups (54% and 51%, respectively) than in non-PGB group (34%), p < 0.001. Incremental drug costs, particularly in PGB subgroups [€34.6 (80.3), €160.7 (123.9) and €154.5 (133.0), for non-PGB, PGBm and PGBadd-on, respectively (p < 0.001)], were off-set by higher significant reductions in all other components of health costs yielding to a greater total cost reductions: -€1,045.3 (1,989.6),-€1,312.9 (1,543.0), and -€1,565.5 (2,004.1), for the three groups respectively (p = 0.03). Conclusion In Spanish primary care settings, PGB given either add-on or in monotherapy in routine medical practice was associated with pain alleviation leading to significant longitudinal reductions in resource use and total costs during the 12-week period of the study compared with non-PGB-therapy of patients with chronic NeP of peripheral origin. The use of non-appropriate analgesic therapies for neuropathic pain in a portion of subjects in non-PGB group could explain partially such findings.

Background and Objective: To achieve a linguistic adaptation and psychometric validation into Spanish of the ID-Pain questionnaire for the screening of differential diagnosis of pain with a neuropathic component., Material and Method: Cross-sectional validation study carried out in 2 phases (cultural adaptation into Spanish language and validation study to test psychometric properties of the scale) in men and women > 18 years, with neuropathic (NP) and nociceptive (NNP) chronic pain for more than 6 months. Feasibility and reliability were explored. Criterion and convergent validity were studied by means of ID-Pain association with reference diagnosis and LANNS (Leeds Assessment of Neuropathic Symptoms and Signs) scale scores. Factor and ROC curves analysis, agreement with reference diagnosis and sensitivity and specificity values were assessed., Results: A total of 283 subjects -64.4% women; mean age (standard deviation): 59.1 (14.9) years-, 145 (51.2%) with NP and 138 (48.8%) with NNP were included in the study. Administration time was 4.2 (3.0) min. Only 15% of participants required help for test completion. Factor analysis indicated a unifactorial solution accounting for 35.5% of the variance. The instrument was time-stable (test-retest r-Pearson = 0.98; p < 0.0005). Mean score differentiated NP from NNP patients; 3.5 (1.2) vs. 1.2 (1.4) (p < 0.0005). Optimum cut-off value was > or = 3 points, showing an area under the curve = 0.89; p < 0.0005, sensitivity value of 0.81, specificity of 0.84 and kappa coefficient of agreement with reference clinical diagnosis of 0.65. The scale also showed good concurrent validity with LANSS classification of subjects (kappa = 0.61; p < 0.0005)., Conclusions: The Spanish version of the ID-Pain questionnaire is feasible, reliable and appropriated as a self-administered screening tool for pain with a neuropathic component.