疼痛与缓解杂志

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Management of Chronic and Neuropathic Pain in Argentina - Evidence, Gaps and Approach

Roberto Rey<span dir="ltr" style="left

Given the different approaches in the management of chronic and neuropathic pain in some developing countries, the present study identified data gaps in patient journey touch-points and proposed solution strategies. The present semi-systematic review included MEDLINE, Embase, and BIOSIS databases and additional sources (Google, Argentine Ministry of Health website and Incidence and prevalence database, and World Health Organization). Fulltext studies on chronic and neuropathic pain in English published from 2010 to 2019 were included. To supplement the data gaps, anecdotal data were provided from local experts. Studies/records without any information on chronic or neuropathic pain, editorials, letters to the editor, thesis abstracts, case studies, or studies regarding patient subgroups or nationally unrepresentative populations were excluded. Weighted or simple means were calculated for the overall data, and the synthesized evidence was represented as an evidence gap map. Of 201 retrieved studies/records, five studies/records met the inclusion criteria. The overall prevalence of patients with chronic pain was low (11%). Despite higher health literacy (62.5%) and patient awareness (70%), treatment accessibility for chronic low back pain (CLBP) was poor. However, the reverse scenario was observed with lower awareness (10%), and a higher number of treated patients (>75%) were found in osteoarthritis (OA). Neuropathic pain-related patient journey mapping indicated alarming values for each touch-point. Patients with chronic pain achieved better pain management than those with neuropathic pain. For better management of patient journey touch-points, adherence to treatment guidelines is warranted. • The patient journey in chronic pain and neuropathic pain in Argentina is non-linear. • There is a great paucity of epidemiology data for both chronic and neuropathic pain in Argentina. • Despite the high degree of health literacy and patient awareness regarding chronic pain, pooled values indicate poor access to diagnostic and therapeutic care in Argentina for such patients. • Neuropathic pain management scenario is even worse than chronic pain with no noticeable positive values from pooled estimates. • As a solution, availability of the latest knowledge, update in the current guidelines, training on differential pain management, continuing medical education, and a multi-sectoral approach in care could be recommended