A snapshot of the prescribing patterns and off‐label use of gabapentinoid agents in tertiary care: a retrospective, cross‐sectional, descriptive study

Abstract

Background: Prescribing of gabapentinoids has increased worldwide and off-label use is well-described. Patients may be at risk of harm from inappropriate use. Prescribing patterns in tertiary care have not been described in the Australian setting. Aim: The aim of this study was to assess the prescribing patterns of gabapentinoids across a Local Health District in New South Wales, Australia. Method: Clinical and prescribing records over a 48-h period were reviewed. Patient demographics, renal function and concurrent opioid use were recorded. Dosing details and the indications for treatment were analysed. Results: Almost 40% of patients were prescribed concomitant opioid therapy, half of which were in the postoperative setting, an indication for which there is little evidence. Appropriate dose reductions were made in the majority of patients with renal impairment. Methods used for ceasing therapy were not in accordance with best practice. Indications for use were difficult to ascertain from medical records. However, only approximately half of usage of both agents appeared to be for approved indications. Conclusion: Prescribing of gabapentinoids could be improved. Although dosages are largely in accordance with recommended dosages for renal impairment, there is significant concern with concurrent use of opioids and use for non-approved indications, many of which lack clinical evidence. Further investigation into prescribing habits in the postoperative setting is warranted. There is a potential role for increased education and intervention to optimise use.