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 |