AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026110128
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ORIGINAL RESEARCH ARTICLE

Bridging the gap between guidelines and clinical practice: Physician management patterns of postherpetic neuralgia in the Tabuk region, Saudi Arabia

Hassan A. Moria1†* ,  Mishari Mohammad Beragdar2† ,  Amirah M. Alatawi3 ,  Bander Yaser Alaqeel1 ,  Abdullah Abdulrahman A. Alharbi1 ,  Raghad Salman K. Alamri1 ,  Abdulmohsen Ahmed Alfarshoti1
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1 Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
2 Department of Surgery, Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia
3 Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
†These authors contributed equally to this work.
EJMO, 026110128 https://doi.org/10.36922/EJMO026110128
Received: 14 March 2026 | Revised: 3 April 2026 | Accepted: 27 April 2026 | Published online: 11 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition following herpes zoster. Despite established guidelines, real-world management patterns remain poorly defined in Saudi Arabia.

Objective: To assess physician involvement, treatment practices, and perceived barriers in PHN management in the Tabuk region.

Methods: A cross-sectional survey was conducted among 113 physicians from multiple specialties. The questionnaire evaluated clinical involvement, use of pharmacologic and topical therapies, referral patterns, and psychosocial assessment practices. Descriptive statistics and categorical tests were applied.

Results: Only 36.3% of physicians reported routine involvement in PHN care, with significant variation across specialties (p < 0.001). Participation was highest among pain/palliative specialists (85.7%), neurologists (66.7%), and dermatologists (47.1%). Awareness of topical therapies was high (92.9%), but clinical use was lower (68.3%). Gabapentinoids (87.8%), tricyclic antidepressants (73.2%), and opioids (63.4%) were commonly prescribed. Key barriers included inefficient referral systems (70.7%), limited access to interventional procedures (68.3%), and lack of standardized protocols (61.0%). Although 95.1% recognized PHN’s quality-of-life impact, only 39.0% routinely assessed psychosocial burden.

Conclusions: PHN management in Tabuk shows limited physician involvement and systemic barriers. Despite high awareness of guidelines, implementation gaps persist, particularly in the use of topical therapy and psychosocial care. Strengthening referral systems and multidisciplinary approaches may improve care delivery.

Keywords
Postherpetic neuralgia
Herpes zoster
Neuropathic pain
Physician practice patterns
Referral systems
Pain management
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare no conflicts of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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