P-043 - (Poster #43) Online CME-certified Survey on Topical Analgesics for Diabetic Peripheral Neuropathy Shows Differential Learning Needs Among Neurologists Relative to Anesthesiologists

Diabetic peripheral neuropathy (DPN) is a frequent consequence of and reflects damage to the peripheral nervous system caused by diabetes. Despite the number of available analgesic pharmacotherapies used to treat DPN none are curative.  Selection of an optimal analgesic treatment regimen should be individualized based on the specific needs of each patient. Topical analgesic therapies represent an important treatment modality for DPN and are associated with positive efficacy and safety in clinical trials.

Purpose/Objectives:

The goal of this study was to gain insight into the gaps in confidence, knowledge, and competence regarding the use of topical analgesic therapies for the management of DPN among anesthesiologists.

Methods:

A continuing medical education (CME)-certified survey consisting of 25 multiple-choice questions on knowledge, competence, and confidence relating to the use of topical analgesic therapies for the management of DPN. The survey was made available to an audience of US-based anesthesiologists and neurologists. Questions were broken into categories related to the pathophysiology, clinical data, and case-based management question regarding the selection of topical analgesics for DPN. Data were collected from December 26, 2024 through March 25, 2025.

Results: A total of 136 anesthesiologists and 110 neurologists completed the survey. In 60% of the 20 knowledge or competence questions, a similar proportion of neurologists and anesthesiologists selected a correct answer. Topics for these questions included risk factors, selection of first line pharmacotherapies, analgesic mechanism of action for approved pharmacotherapies, and clinical trial outcomes in DPN. For the remaining questions there was at least a 15% relative difference between the two physician groups in selecting a correct answer.  51% more neurologists correctly identified the diagnostic use of skin biopsy in DPN relative to anesthesiologists. A greater proportion of anesthesiologists relative to neurologists correctly answered questions pertaining to the use of off-label analgesics in DPN, clinical trial outcomes of the PACE trial of topical capsaicin, the clinical benefit of compounded topical analgesics, and when to consider the clinical use of topical analgesics for the management of DPN. 

Conclusions/Implications for future research and/or clinical care:

This study demonstrated that anesthesiologists and neurologists are equally aware of many aspects of the use of the initial management of DPN. The data also revealed that future education for anesthesiologists should address the use of diagnostic skin biopsies, whereas neurologists would benefit most from education on clinical trial data and clinical cases involving the use of topical analgesics.