Leading pharmacist experts in the Asia-Pacific region, along with P&G Health, have introduced the first guidelines aimed at helping community pharmacists recognize, evaluate, and treat patients with peripheral neuropathy (PN) in everyday pharmacy work.
The “Empowering Community Pharmacists – Expert Consensus Guidelines for the Effective Management of Peripheral Neuropathy with Neurotropic B Vitamins” provides clear and practical recommendations. These guidelines are designed to help standardize the ways pharmacists screen, counsel, and manage patients, addressing the ongoing issues of missed diagnoses and delays in treatment.
Dr. Yolanda R. Robles (Lead Author, Chairperson), Professor, College of Pharmacy, University of the Philippines; President of Federation of Asian Pharmaceutical Associations (FAPA) said, “PN is a widespread and often debilitating condition that has high prevalence amongst diabetic patients in APAC 3-7 – the Philippines (58%), Indonesia (58%), Malaysia (54%), Thailand (34%), Singapore (28%), and Australia (21%). With pharmacists being the most accessible health professional in many APAC countries, this consensus translates the best available evidence into simple steps for pharmacists to spot PN earlier, guide patients confidently, and partner physicians to improve long-term outcomes.”
Why this matters in Asia Pacific
Shraddha Vohra, Vice President, Personal Health Care Asia Pacific, P&G Health Singapore said, “Community pharmacies are often the first point of contact for people experiencing numbness, tingling, burning, or pins-and-needles in their hands and feet—symptoms commonly associated with PN. With up to 80% of PN cases in APAC estimated to remain undiagnosed, pharmacists are uniquely positioned to recognize symptoms early, guide patients to appropriate care, and help prevent progression. This guideline is tailored to the realities of pharmacy workflows, multilingual communities, and varied regulatory environments across APAC, and beyond, with tools that can be adapted locally to support rapid adoption.”
Reframing the role of pharmacists: from reactive management to proactive early screening and timely treatment
According to Contributing Author Dr. Apt. Lusy Noviani, Indonesian Pharmacist Association (IAI),”From behind the counter to the frontline, APAC pharmacists are moving from dispensing to early detection and proactive care. In countries like Indonesia, where doctor-to-population ratios are low, community pharmacists play a critical role in early screening and reducing delays in PN care.”
The new guidelines enable pharmacists to function as proactive care partners throughout the PN pathway by empowering them to:
- Spot at-risk patients early by applying a newly-created risk mnemonic (MEDIC)
- Differentiate nerve pain from muscle pain
- Use simple, validated screening questionnaires in-pharmacy (e.g., ACT, DN4, NPQ)8
- Initiate counselling, consider appropriate over-the-counter options including high-dose nerve nourishing B vitamins (B1, B6, B12) when suitable, and refer promptly when red flags are present
- Monitor and follow up to evaluate response, ensure safety and adjust individualized patient care plans
Spot PN early with MEDIC
“In busy pharmacy settings, simple tools matter. MEDIC is an easy-to-remember risk mnemonic that stands for M – Medication, E – Elderly, D – Diabetes, I – Infection, C – Chronic. Using MEDIC, pharmacists can flag patients at high risk of nerve damage early— without diagnosing, but by guiding next steps,” shared Dr. Navin Kumar Loganadan, Contributing Author & Head of Ambulatory Pharmacy & DMTAC (Diabetes Medication Therapy Adherence Clinic) Clinic, Malaysia.
“PN is often discovered late when nerve pain is severe. Our guideline empowers pharmacists to differentiate nerve from muscle pain early, apply validated screening tools, and initiate timely referrals. This shift from reaction to prevention can help patients restore nerve function and independence,” added Ms. Grace Chew, Independent Pharmacist & Contributing Author, Singapore.
From screening to support: A clear care pathway
Dr. Kenny James P. Merin, Contributing Author & Lyceum of the Philippines University – Davao (LPU Davao) shared, “This guideline is about practical, everyday pharmacy. The steps are clear: identify risk, screen, counsel, consider therapeutic-dose B1, B6, and B12 where appropriate, and follow up consistently. With structured algorithms and checklists, pharmacists can standardize care without slowing workflow.”
It is common for patients to self-medicate for PN with vitamin B products, often using inappropriate dosage. This can lead to a lack of efficacy due to an insufficient dose or, conversely, overdose from certain B vitamins, which can worsen nerve-related symptoms. This is therefore an area where pharmacists can provide critical oversight toward improving patient outcomes.
“Therapeutic-dose neurotropic B vitamins have a role in comprehensive PN management for suitable patients with the right dose and duration. Our guideline emphasizes pharmacist vigilance—reassessing at 3–6 months, watching for red flags, and collaborating closely with physicians,” added Dr. Kitiyot Yotsombut, Contributing Author, Department of Pharmacy Practice, Chulalongkorn University, Thailand.
Access and implementation
The expert consensus guideline will be made available for APAC pharmacists via a newly launched resource portal, P&G Nerve Connect and expert-led webinars in the Philippines, Indonesia, Malaysia, Thailand, Singapore.
“Behavior change is never easy, our recent pharmacist survey in the Philippines showed that those completing five or more training sessions demonstrate significantly better knowledge on the right dose of B vitamins for PN. P&G Health’s Nerve Connect provides an always-on omnichannel education solution, transforming paper-based guidelines into engaging, everyday pharmacist practices,” added Dr. Yolanda R. Robles.
Shraddha Vohra from P&G shared, ” P&G Nerve Connect is a one-stop center for nerve health bringing together real-world patient case insights and practical tools to help pharmacists enhance patient interactions and strengthen everyday clinical decision-making. Pharmacists who face high patient flow, multiple tasks and limited capacity will have access to resources such as checklists and training videos. In addition, they will be encouraged to submit their patient cases to inspire their community and exchange learnings across APAC.”
To access the first APAC Pharmacists’ Guidelines for PN, visit https://mobile.swiperxapp.com/png-nerveconnect-ph/clinical-guideline/
To access P&G Nerve Connect, visit https://mobile.swiperxapp.com/png-nerveconnect-my/
Note to readers: The guideline is unbranded and intended for healthcare professional use. It complements, not replaces, physician diagnosis and care. Pharmacists should adhere to local regulations governing scope of practice, screening, and referral.