Asia‑Pacific Pharmacists Release First Community Guideline for Peripheral Neuropathy Care

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Pharmacist leaders from across Asia‑Pacific, working with P&G Health, have released the region’s first expert consensus guideline to help community pharmacists identify, assess, and support patients with peripheral neuropathy (PN) in daily practice.

The guideline was launched during the media roundtable on ‘Setting the Standard in Peripheral Neuropathy (PN) Care: Empowering Pharmacists with the New PN Guideline’ to which PP Health Malaysia (PPHM) was invited.

Titled “Empowering Community Pharmacists – Expert Consensus Guidelines for the Effective Management of Peripheral Neuropathy with Neurotropic B Vitamins”, the guideline converts existing clinical evidence into practical recommendations that can be adapted across different cultures, pharmacy settings, and regulatory systems.

Its aim is to improve early recognition of PN, standardise counselling and referral practices, and reduce delays in treatment.

A common but often missed condition

Malaysia has one of the highest diabetes prevalence rates in Asia, with nearly 1 in 5 adults affected, putting millions at risk of silent complications such as Peripheral Neuropathy (PN). Affecting more than half of people with diabetes, PN prevalence is estimated to reach up to 60.9% among older Malaysians, reported by regional studies, highlighting a significant gap in early detection.

Peripheral neuropathy is common in Asia‑Pacific, particularly among people with diabetes. Reported prevalence rates include the Philippines (58%), Indonesia (58%), Malaysia (54%), Thailand (34%), Singapore (28%), and Australia (21%). Experts estimate that up to 80% of PN cases in the region remain undiagnosed, according to the pharmacist leaders.

Dr Yolanda R. Robles, Lead Author and Professor at the University of the Philippines College of Pharmacy, said the guideline recognises the central role of pharmacists in many APAC health systems.

“Pharmacists are often the most accessible health professionals. This consensus provides clear, evidence‑based steps to help them recognise possible PN earlier, guide patients appropriately, and work with physicians to support long‑term care,” she said in a press release shared with PP Health Malaysia (PPHM).

Designed for everyday pharmacy practice

Community pharmacies are frequently the first place people seek help for symptoms such as numbness, tingling, burning, or pins‑and‑needles in the hands and feet. The guideline is structured around typical pharmacy workflows and includes tools that can be used during routine interactions.

Key elements include guidance for pharmacists to:

Identify people at higher risk using a simple risk mnemonic, MEDIC
(Medication, Elderly, Diabetes, Infection, Chronic conditions)
Distinguish nerve‑related pain from muscle or joint pain
Use short, validated screening questionnaires such as ACT, DN4, and NPQ
Provide counselling, recommend suitable over‑the‑counter options where appropriate, and refer patients when warning signs are present
Monitor progress and follow up to assess response and safety

Dr Navin Kumar Loganadan, a contributing author from Malaysia, noted that simple tools are essential in busy pharmacies. “MEDIC allows pharmacists to flag potential risk early and guide next steps, without making a diagnosis,” he said.

Addressing self‑medication and vitamin use

The guideline also addresses common self‑medication practices. Many patients use vitamin B products for PN symptoms, sometimes at doses that are too low to be effective or, in other cases, at levels that may increase the risk of side effects.

Contributors emphasised that pharmacists can help ensure appropriate dosing, duration, and follow‑up when neurotropic B vitamins (B1, B6, and B12) are considered, and can reassess patients over time and refer to doctors when needed.

Supporting pharmacists across APAC

The guideline will be made available to pharmacists across Asia‑Pacific through an online resource platform, P&G Nerve Connect, along with webinars and training programmes in the Philippines, Indonesia, Malaysia, Thailand, and Singapore.

According to the authors, the goal is to support consistent, practical application of the recommendations rather than replace medical diagnosis or specialist care.

By focusing on early identification, structured screening, and timely referral, the guideline aims to strengthen the role of community pharmacists in the care pathway for peripheral neuropathy and help reduce the impact of delayed recognition across the region.

Disclosure: The guideline was developed by an independent panel of pharmacist experts with educational support from P&G Health. The guideline initiative is supported by P&G Health. PP Health Malaysia (PPHM) received NO sponsorship, payment, or gifts from P&G Health for this press release.

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