000170225 001__ 170225
000170225 005__ 20260407115449.0
000170225 0247_ $$2doi$$a10.1002/ejp.70246
000170225 0248_ $$2sideral$$a148759
000170225 037__ $$aART-2026-148759
000170225 041__ $$aeng
000170225 100__ $$aHuerta, Miguel Á.
000170225 245__ $$aPrescription Trends and Clinical Decision‐Making in Neuropathic Pain Pharmacological Treatment: Results From a Cross‐Sectional Survey by the Spanish Pain Society
000170225 260__ $$c2026
000170225 5060_ $$aAccess copy available to the general public$$fUnrestricted
000170225 5203_ $$aNeuropathic pain (NP) is a complex chronic condition with limited therapeutic effectiveness. Despite multiple drug classes and international guidelines, real-world adherence remains inconsistent, and data on prescribing practices among pain specialists is scarce.
Methods. We conducted a nationwide cross-sectional survey among members of the Spanish Pain Society in May 2025. A structured 62-item questionnaire assessed prescribing habits, decision-making criteria, guideline adherence, dosage patterns, and the recognition and management of tolerance. Sociodemographic and professional data were also collected.
Results. A total of 220 pain specialists (52% female) completed the survey; 28% had over 20 years of clinical experience. Satisfaction with current pharmacological options was modest, with 52% reporting dissatisfaction or indifference. Prescribing was mainly guided by clinical experience (43%) and guideline recommendations (36%). Gabapentin (45%) and pregabalin (40%) were the most frequent first-line choices, followed by tricyclic antidepressants (amitriptyline; 9%), duloxetine (5%) and venlafaxine (1%). Tramadol dominated second-line use (65%), followed by capsaicin (22%) or lidocaine (5%) patches. Half of the participants reported tolerance, typically after 3–12 months, managed mainly by dose escalation or switching drug classes. Dosage practices for gabapentinoids and antidepressants showed marked heterogeneity, with frequent deviations from recommended titration protocols.
Conclusions. NP management in Spain shows variability and partial alignment with international guidelines. Gabapentinoids, tricyclic antidepressants and duloxetine remain preferred treatments, but reliance on personal experience and awareness of tolerance hinder evidence-based practice. Quantifying Spanish pain specialists' views on tolerance supports calls for national consensus, better dosing education and further research to harmonise care and improve outcomes.
Significance. This nationwide survey provides the first systematic assessment of neuropathic pain management in Spain, revealing marked variability, only partial adherence to international guidelines, and persistent reliance on clinical experience over evidence. It confirms gabapentinoids, tricyclic antidepressants and duloxetine as preferred treatments, identifies continued tramadol use despite conflicting recommendations, and quantifies for the first time clinicians' perception and management of tolerance. These findings fill a major evidence gap and directly inform future national consensus, educational initiatives and clinical practice improvement.
000170225 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000170225 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000170225 700__ $$aMayo-Moldes, Mónica
000170225 700__ $$aGarcia, Miguel M.
000170225 700__ $$aGarcía-Parra, Beliu
000170225 700__ $$aMatute, Mercè
000170225 700__ $$aLópez-Tofiño, Yolanda
000170225 700__ $$aPaniagua, Nancy
000170225 700__ $$0(orcid)0000-0001-9678-3449$$aHernández-Secorún, Mar
000170225 700__ $$aSoler, Dolors
000170225 700__ $$aSalmerón, Marcos
000170225 700__ $$aTaylor, Julian
000170225 700__ $$aVerdú, Enrique
000170225 700__ $$aValencia, José A.
000170225 700__ $$aPico, Silvia
000170225 700__ $$aDíaz-Alejo, Clara
000170225 700__ $$aKatsuki, Masahito
000170225 700__ $$aSerrano-Afonso, Ancor
000170225 700__ $$aRuiz-Cantero, M. Carmen
000170225 773__ $$g30, 3 (2026), 15 pp.$$pEuro. j. pain$$tEUROPEAN JOURNAL OF PAIN$$x1090-3801
000170225 8564_ $$s4554273$$uhttps://zaguan.unizar.es/record/170225/files/texto_completo.pdf$$yVersión publicada
000170225 8564_ $$s2817349$$uhttps://zaguan.unizar.es/record/170225/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000170225 909CO $$ooai:zaguan.unizar.es:170225$$particulos$$pdriver
000170225 951__ $$a2026-03-26-14:32:04
000170225 980__ $$aARTICLE