619: Patient-Physician Differences in Pain Treatment Satisfaction for Diabetic Peripheral Neuropathy

Topic: Education, Societal Impact, and Others
Subtopic: Education of pain care

Background and Aims: Diabetic peripheral neuropathy (DPN) is the most prevalent chronic complication of diabetes.1 Diabetes is a risk factor for pain in patients with distal sensory polyneuropathy, and approximately 50% of DPN patients in some samples report pain and associated reduction in quality of life (QoL) and activity interference.1,2 Optimal pain relief using a shared decision-making approach requires concordant priorities among patients and clinicians.3 When implemented effectively, patient-centered care improves treatment adherence, patient satisfaction, QoL, and other clinical outcomes.4 This analysis describes physician-and patient-reported prescription treatment satisfaction for painful DPN (pDPN) and identifies factors associated with treatment satisfaction.

Methods: Data were drawn from Adelphi Real World pDPN Disease Specific Programme™ cross-sectional surveys conducted in the US (April-November 2024). Physicians completed forms for 799 consecutively consulted patients with pDPN on demographics, clinical characteristics, treatments, and physician-reported satisfaction; 243 of these patients completed self-reported surveys capturing symptom burden, health-related QoL (HR-QoL), and treatment satisfaction. Satisfaction with current pDPN medications across efficacy, safety, tolerability, HR-QoL, and convenience was assessed using 5-point Likert scales. Physician-and patient-reported satisfaction (defined as extremely or somewhat satisfied) were examined using elastic net logistic regression for variable selection, followed by unpenalized logistic regression to estimate odds ratios (ORs).

Results: Among 214 patients with matched physician-patient satisfaction data, physicians frequently reported being extremely satisfied (50% vs 21%), while more patients reported somewhat satisfied (56% vs 37%) or neutral (16% vs 8%). Lower physician-rated satisfaction was associated with decreased diabetes control satisfaction (OR=0.36), Medicare Advantage (MA; 0.12), duloxetine use (0.24), and current treatment issues (0.14). Lower patient satisfaction was associated with fatigue (0.77), pDPN flares (0.16), MA (0.03), and exercise-based interventions (0.13). Longer treatment (1.60) and HR-QoL (1.62) were associated with higher satisfaction. Physicians identified burning, tingling, prickling as most troublesome symptoms (30-33%); patients reported tingling, burning, pins and needles (45-63%).

Conclusions: In this real-world pDPN population, physicians reported descriptively higher treatment satisfaction than patients, highlighting physician-patient perceptual gaps that may affect shared decision-making. MA coverage was a common driver of lower satisfaction for both groups. Physicians’ satisfaction was more significantly associated with diabetes control and treatment selection, whereas patients’ satisfaction was strongly associated with fatigue, flares, and exercise-based interventions. These results demonstrate the need for more patient-centered pDPN management strategies that address both clinical outcomes and QoL challenges, while ensuring alignment between physician and patient expectations for care.

References: 1. Tao Y, et al. Diabetes Res Clin Pract, 2025;222:112099.
2. Hicks CW, et al. Curr Diab Rep. 2019;19(10):86.
3. Wang MJ, et al. Patient Prefer Adherence. 2019;13:871-879.
4. Chen TT, et al. World J Diabetes. 2024;15(7):1417-1429.

Presenting Author: Gilwan Kim
Submitting Author: Gilwan Kim

Senior Author: John Markman

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Rebecca L. Robinson: MS - Eli Lilly and Company, Indianapolis, IN, USA
• Marcia Maria Mellado Lagardo: PhD, MS - Eli Lilly and Company, Indianapolis, IN, USA
• Ekin Seçinti: PhD - Eli Lilly and Company, Indianapolis, IN, USA
• Lucy Hargreaves: BSc - Adelphi Real World, Bollington, UK
• Sophie Barlow: MSc - Adelphi Real World, Bollington, UK
• Ashley Mortimer: MSc - Adelphi Real World, Bollington, UK
• Lewei Duan: PhD - R2 Technology, King of Prussia, PA, USA
• David Provenzano: MD - Pain Diagnostics and Interventional Care, Sewickley, PA, USA.
• Sahil Gupta: M.B.B.S., MD - Mayo Clinic, Jacksonville, FL, USA
• John Markman: MD - Eli Lilly and Company, Indianapolis, IN, USA