Objective:

This analysis aimed to investigate the point prevalence, causal risk factors, and treatment utilization in distal sensory polyneuropathy (DSP).

Background:

DSP is a common neurologic disease characterized by pain and/or other symptoms that can stem from multiple causes of nerve injury.

Design/Methods:

In this retrospective cohort analysis, adults with ≥1 DSP claim were identified from large commercial and Medicare Advantage health plans from January 2017 through February 2023, using Optum^® Clinformatics Data Mart. Patients were categorized into cohorts by DSP type (diabetic, nondiabetic, or mixed), and their use of medical and pharmacy services, including indicators of painful DSP, were analyzed over 12 months.

Results:

Approximately 2 million adults had DSP claims. Diabetes was the most common cause (55.9% of patients), yet 37.4% of these individuals also had claims associated with nondiabetic causes of DSP (mixed). Approximately 25.0% of patients had idiopathic DSP claims and 43.9% had “unspecified” DSP claims. Antihypertensives and analgesics were the most commonly prescribed medications. Among the analgesics, opioids and gabapentinoids were most frequently used (40.7% and 38.1% of patients, respectively). Patients with mixed DSP tended to have higher pain prevalence, comorbidity rates, analgesics, and select nonpharmacologic treatments than those with diabetic or nondiabetic causes of DSP. The presence of pain in each of these cohorts increased the rates of medication use (for pain and other conditions) and other pain, mental health, and sleep disturbance diagnoses.

Conclusions:

This analysis examined risk factors for DSP and its prevalence in real-world clinical practice. Data are limited due to the common use of nondescript/unspecified codes. However, there appears to be a cumulative burden when multiple risk factors are present as illustrated by the higher rates of analgesic and nonpharmacologic pain treatments and comorbid conditions regardless of whether diabetes was present.