Date of Award

2014

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not oral dextromethorphan provides pain relief in patients with diabetic neuropathy.

STUDY DESIGN: Review of three peer-reviewed, double blind, randomized control trials published between 1995-2012.

DATA SOURCES: Studies were selected through Cochrane Library Collection and PubMed and chosen based on their relevance to the clinical question as well as their inclusion criteria; including adults over the age of 18; and those who were experiencing daily pain of moderate intensity, for at least half of the day, over a span of 3 months.

OUTCOMES MEASURED: Each RCT measured the same outcome but in a different way. In the Nelson study, pain relief was measured using a 13-word descriptor scale; for the Sani study, pain relief was measured using a category rating scale; and the Shaibani trial measured pain relief using a Pain Relief Rating scale.

RESULTS: It was assessed and recorded in all three RTCs that the efficacy of oral dextromethorphan in pain relief was statistically significant when compared to a placebo.

CONCLUSIONS: Oral dextromethorphan has been shown to give pain relief to patients with diabetic neuropathy. With further research using larger sample sizes and assessment of long-term adverse reactions, dextromethorphan may be made a common treatment for diabetic neuropathy.

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