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Analysis of Comorbid Conditions and Drug Utilization Patterns in Neuropathic Pain (The NEUTRON study)

BASIC DETAILS

Patient code (Do not write name here) *

Date *

Diagnosis (Diagnosed with Neuropathic Pain)

Patient's Age (years) *

Gender *

Male Female

Height (in cm) *

Weight (in Kg) *

Obesity (BMI) *

Underweight (<18.5 kg/m²) Normal BMI (18.5-22.9 kg/m²) Over weight (23.0 -24.9 kg/m²) Obese (>25 kg/m²)

Active Smoker *

Yes No

Presenting symptoms at the time of diagnosis *

Allodynia Paresthesia Burning sensation Shooting pain/Electric shock like Intolerance to temperature Any Other

Selected pharmacotherapy strategy *

Monotherapy Combination therapy

Prescribed drug for neuropathic pain *

Have you noticed any changes in the intensity or frequency of your neuropathic pain since starting treatment? *

Yes No

Pain intensity baseline *

Pain intensity post treatment *

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