Table 1

Attributes and levels identified for consideration in determining refractoriness of neuropathic pain, and subsequent consensus among participants
Median (/5)* Mean* Level of consensus,% (n) Final consensus on inclusion/exclusion (>70%)
Minimum duration of NeuP
Three months 4.00 4.05 89.5% (17) disagree/strongly disagree YES
Six months 3.00 2.89 36.8% (7) strongly agree/agree NO
More than one year 2.00 2.53 52.6% (10) strongly agree/agree NO
Duration irrelevant 3.00 3.05 42.1% (8) strongly agree/agree NO
Minimum number of drugs of known effectiveness for NeuP tried
Two drugs 4.00 3.83 72.2% (13) disagree/strongly disagree YES
Three drugs 2.00 2.44 66.7% (12) strongly agree/agree NO
Four drugs 2.00 1.78 88.9% (16) strongly agree/agree YES
More than four drugs 1.00 1.39 94.5% (17) strongly agree/agree YES
An adequate trial of NeuP treatment
One week 5.00 4.78 100% (18) disagree/strongly disagree YES
One month 3.00 3.17 31.6% (6) strongly agree/agree NO
Three months 2.00 2.06 83.5% (15) strongly agree/agree YES
Until adverse effects prevent adequate dosage 1.00 1.63 89.5% (17) strongly agree/agree YES
Outcomes of pain treatment
Pain levels of 5 or more on a 0–10 pain scale 2.00 2.61 83.3% (15) strongly agree/agree YES
Less than 30% pain intensity reduction 2.00 2.06 88.9% (16) strongly agree/agree YES
No period of pain remission 2.00 2.12 82.4% (14) strongly agree/agree YES
An increase in pain severity 2.00 1.78 77.8% (14) strongly agree/agree YES
Quality of life remains significantly affected by pain (e.g. sleep, activity limitations, mood, disability) 2.00 1.83 83.3% (15) strongly agree/agree YES
Usefulness of other non-drug therapies
Non-pharmacological therapies must be tried before neuropathic pain is considered refractory (e.g. TNS, physical therapy, psychological therapy, relaxation) 2.00 2.58 63.2% (12) strongly agree/agree NO
No response to spinal cord stimulator 4.00 3.89 73.7% (14) disagree/strongly disagree YES

*1 = strongly agree to 5 = strongly disagree, lower mean/ median score = higher agreement.

Smith et al.

Smith et al. BMC Neurology 2012 12:29   doi:10.1186/1471-2377-12-29

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