Patients’ and prescribers’ experiences of managing neuropathic pain with medication: a scoping review

Background: Neuropathic pain (NP) is a chronic condition that affects patients’ quality of life. Prescribing for NP within primary care is variable. There is a need to understand NP medicine management from both patient and prescribers’ perspectives. This scoping review aimed to identify, synthesise and identify gaps in the literature on the experiences of: i) prescribers in prescribing medicines to manage the symptoms of NP and ii) people with NP who use prescribed medicines to manage their symptoms.

Methods: Four electronic bibliographic databases (Medline, CINAHL, Embase and PsycInfo) were searched from inception to the end of October 2022 using a structured search strategy. The findings were synthesised and presented using a modified framework for monitoring opioid prescribing called the 5 A’s framework. The 5 A’s are Analgesia, Activities of daily living, Adverse effects, Aberrant behaviour, and Activities and actions of healthcare professionals.

Results: From the 10,995 records identified, 11 studies were included in the review. All the studies focused on patients' experiences, with no studies about the experiences of prescribers in managing NP. Patients reported that medicines seem to work at the outset but, over time, are less effective in relieving their pain. Patients took less than the prescribed dose of their medicine, depending on their pain level on the day. Taking medication allowed patients to participate in activities they would not otherwise have been able to do, often resulting in less isolation and loneliness.

Conclusions: This scoping review has highlighted patients' experiences of using medicines to manage NP. Results provide insight into how patients cope with inadequate pain control and the impact this has on patients’ lives. More research is required to explore the experiences of people living with non-specific types of NP as well as the experiences of prescribers who prescribe medicines to manage NP.