Predictors of duloxetine versus other treatments among veterans with diabetic peripheral neuropathic pain: a retrospective study
Pain Practice,  Clinical Article

Zhao Y et al. – Diabetic peripheral neuropathic pain (DPNP) patients in the veterans affairs (VA) healthcare system with prior other treatment use, select comorbid conditions, prior substance abuse, prior opioid use, and higher pain level were more likely to receive duloxetine.

Methods
  • The electronic medical and pharmacy records from January 2004 to December 2008 were requested from the Veterans Integrated Service Network 16 data warehouse.
  • All select patients received either duloxetine or other treatments [tricyclic antidepressants (TCAs), venlafaxine, gabapentin, and pregabalin] over the study period, with the first dispense date of the index agent as the index date.
  • All patients must have 1+ prior DPNP diagnosis (ICD–9–CM: 250.6x or 357.2), but no diagnoses of prior depression (ICD–9–CM: 296.2, 296.3, 300.4, 309.1, or 311.0), fibromyalgia (ICD–9–CM: 729.1), or neuralgia (ICD–9–CM: 729.2).
  • Logistic regression was used to examine the predictors of receiving duloxetine versus other treatments, controlling for demographics, comorbidities, prior pain level, prior use of other medications, and opioid use.

Results
  • The analytical sample included 2,694 patients (duloxetine cohort, n = 216; other–treatment cohort, n = 2,478).
  • Prior uses of gabapentin (odds ratio [OR] = 13.66, 95% confidence interval [CI]: 9.70–19.24), TCAs (OR = 5.40, 95% CI: 3.73–7.82), or venlafaxine (OR = 3.67, 95% CI: 1.67–8.06) were strong predictors of duloxetine.
  • Other comorbidities associated with duloxetine were anxiety (OR = 2.08, 95% CI: 1.40–3.08), cerebrovascular disease (OR = 1.44, 95% CI: 1.01–2.07), and substance abuse (OR = 2.11, 95% CI: 1.10–4.03).
  • Prior opioid users were 1.47 (95% CI: 1.02–2.12) times as likely to receive duloxetine as those without prior opioid use.
  • Patients with self–reported severe pain were 1.66 (95% CI: 1.11–2.50) times as likely to receive duloxetine as those with no pain reported.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...

Your Unread Messages in Neurology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

<

Most Popular Neurology Articles

1 A new way to diagnose brain damage from concussions, strokes, and dementia Tufts University News, December 16, 2014

2 Clopidogrel plus aspirin aspirin alone for preventing early neurological deterioration in patients with acute ischemic stroke Journal of Clinical Neuroscience, November 13, 2014    Clinical Article

3 Effect of addition of clopidogrel to aspirin on subdural hematoma: Meta-analysis of randomized clinical trials International Journal of Stroke, December 5, 2014    Evidence Based Medicine    Review Article    Clinical Article

4 Effect of alteplase within 6 hours of acute ischemic stroke on all-cause mortality (Third International Stroke Trial) Stroke, November 26, 2014    Clinical Article

5 Effects of antiplatelet agents on functional outcome and cognitive status in patients with acute ischemic stroke Full Text International Journal of Gerontology, November 21, 2014    Free full text    Clinical Article

6 Antithrombotic therapy after acute ischemic stroke in patients with atrial fibrillation Stroke, November 25, 2014    Clinical Article

7 25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease Stroke, December 24, 2014    Clinical Article

8 Optimal combination secondary prevention drug treatment and stroke outcomes Neurology®, December 9, 2014    Clinical Article

9 Alteplase for the treatment of acute ischaemic stroke: A NICE Single Technology Appraisal; An evidence review group perspective PharmacoEconomics, December 1, 2014    Review Article

10 Prediction of recurrent stroke with ABCD2 and ABCD3 scores in patients with symptomatic 50-99% carotid stenosis Full Text BMC Neurology, December 11, 2014    Free full text    Clinical Article

11 Clopidogrel plus aspirin versus warfarin in patients with stroke and aortic arch plaques Stroke, May 2, 2014    Clinical Article

12 Association of statin use and risk for severe headache or migraine by serum vitamin D status: A cross-sectional population-based study Cephalalgia, December 1, 2014    Clinical Article

13 Effects of differences in serum total homocysteine, folate, and vitamin B12 on cognitive impairment in stroke patients Full Text BMC Neurology, December 4, 2014    Free full text    Review Article

14 Effects of blood pressure lowering in patients with acute ischemic stroke and carotid artery stenosis International Journal of Stroke, December 16, 2014    Clinical Article

15 Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials The Lancet, August 11, 2014    Evidence Based Medicine    Clinical Article

16 Risk of stroke associated with nonsteroidal anti-inflammatory drugs Full Text Vascular Health and Risk Management, January 13, 2014    Free full text    Review Article    Clinical Article

17 Thrombolysis and clinical outcome in patients with stroke after implementation of the Tyrol Stroke Pathway: a retrospective observational study The Lancet Neurology, December 2, 2014    Clinical Article

18 Marijuana use associated with lower death rates in patients with traumatic brain injuries Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center News, November 11, 2014

19 Ischemic stroke and intracranial hemorrhage with aspirin, dabigatran, and warfarin Stroke, December 23, 2014    Clinical Article

20 Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open-label, parallel-group trial International Journal of Stroke, December 10, 2014    Clinical Article

Indexed Journals in Neurology: Current Opinion in Neurology, Stroke, Seizure, Cephalgia, Brain Injurymore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List