Examining the Prevalence of Neuropathic Pain

Key Takeaways

• In a Malaysian general-population screening sample, 18.3% screened positive for probable neuropathic pain. Among participants with diabetes, 40.1% screened positive for probable neuropathic pain.
• In a discrete choice experiment, 82.1% of participants showed poor-to-moderate recognition of neuropathic pain symptoms.

Neuropathic pain can remain underrecognized when patients do not clearly distinguish it from nociceptive pain, and treatment selection may be shaped as much by tolerability as by expected benefit. A study of probable neuropathic pain burden and treatment preferences in Malaysia used a digital ID-Pain questionnaire across nine tertiary hospitals to screen for probable neuropathic pain (NeuP); the screening cohort included 13,592 adults, and 17.1% had diabetes. A separate discrete choice experiment (DCE) cohort included 3,999 participants and assessed differentiation of neuropathic versus nociceptive symptoms, along with preferences for perceived pain reduction, time to effect, proven effectiveness, risk of common side effects, and cost.

Screen-positive probable NeuP was common overall, more frequent among participants with diabetes, and accompanied by poor-to-moderate symptom recognition in most DCE participants. Treatment choices in the preference experiment were driven most strongly by avoiding a high risk of common side effects (coefficient -1.744, 95% CI -1.820 to -1.669), followed by preference for strong scientific evidence (coefficient 1.237, 95% CI 1.182 to 1.291), with significant cost sensitivity also reported (coefficient -5.565, 95% CI -6.909 to -4.221).

These prevalence figures referred to screen-positive probable NeuP rather than confirmed clinical diagnosis.

Clinician Questions

What does screen-positive probable neuropathic pain mean in the Malaysian analysis?

In this analysis, screen-positive probable neuropathic pain meant a positive result on the digital ID-Pain questionnaire used in Malaysian tertiary-hospital settings, so the prevalence figures reflected probable NeuP identified by screening rather than confirmed clinical diagnosis.

Which treatment features were compared in the neuropathic pain discrete choice experiment?

The discrete choice experiment compared perceived pain reduction, time to effect, proven effectiveness, risk of common side effects, and cost, and it also assessed participants' ability to distinguish neuropathic from nociceptive symptoms.