Quality of life increases in patients with painful diabetic neuropathy following treatment with spinal cord stimulation

Rui Duarte, Lazaros Andronis, Mathieu Lenders , Cecile de Vos

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    This study aims to explore the changes in pain intensity and quality of life (QoL) experienced by patients with painful diabetic neuropathy (PDN) treated with spinal cord simulation (SCS) and conventional medical practice (CMP).
    Patient-reported pain intensity and QoL data were obtained from participants in an international multicentre randomised controlled trial comparing SCS versus CMP. Data were collected at randomisation and 6 month follow up by means of a visual analogue scale for pain intensity (VASPI), the EuroQoL Visual Analogue Scale (EQ VAS) and the EuroQol EQ-5D index. Quality-adjusted life years (QALYs) were calculated for each treatment using the ‘area under the curve’ method. Differences in QALYs were calculated after adjusting for between-treatment imbalances in baseline QoL.
    At six months, patients allocated to SCS reported larger reductions in pain intensity and improvements in QoL measured by the EQ-5D utility score and EQ-VAS as compared to those allocated to CMP. Initial calculations of QALYs for the SCS and CMP groups suggested no statistical differences between the groups. Adjusting for imbalances in baseline EQ-5D scores showed SCS to be associated with significantly higher QALYs compared to CMP.
    SCS resulted in significant improvement in pain intensity and QoL in patients with PDN, offering further support for SCS as an effective treatment for patients suffering from PDN. From a methodological point of view, different results would have been obtained if QALY calculations were not adjusted for baseline EQ-5D scores, highlighting the need to account for imbalances in baseline QoL.
    Original languageEnglish
    Pages (from-to)1771–1777
    Number of pages7
    JournalQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
    Issue number7
    Early online date22 Dec 2015
    Publication statusPublished - Jun 2016


    • EuroQoL-5D
    • Neuropathic pain
    • Painful diabetic neuropathy
    • Quality Of Life
    • Spinal cord stimulation


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