Awareness of Lebanese Pharmacists towards the Use and Misuse of Gabapentinoids and Tramadol: A Cross-sectional Survey

Abstract

Community pharmacists are the most accessible healthcare professionals. Recently, the increasing trend of tramadol and gabapentinoids prescription has become a global problem, with a high risk of misuse and abuse. This study mainly assessed the knowledge and practice of Lebanese pharmacists regarding the use of gabapentinoids and tramadol, and also identified the predictors of knowledge. A cross-sectional survey was conducted on a sample of 295 Lebanese community pharmacists over a period of 4 months. Data were collected using a questionnaire filled online by the participants. Knowledge scores for tramadol and gabapentinoids together and for each separately were computed and dichotomized into poor and good knowledge. Data were analyzed using SPSS version 22 (SPSS Inc., Chicago, IL, USA). The mean scores of tramadol and gabapentinoids knowledge individually were 18 ± 7 and 18 ± 6, respectively; 52.9% and 52.5% had good knowledge, whereas 47.1% and 47.5% had poor knowledge concerning these drugs, respectively. Moreover, it was observed that having a master's degree increases knowledge about tramadol and gabapentinoids by approximately two times. Regarding pharmacists' practice concerning tramadol and gabapentinoids dispensing, 97.6% and 71.5% of pharmacists, respectively, do not dispense them without prescription. About 43% of pharmacists believe that current governmental regulations are not adequate to control the problem of misuse, with 86.8% citing the need for new laws and better supervision on such drugs to limit their misuse. This study highlighted that pharmacists' knowledge concerning tramadol and gabapentinoids needs to be improved, reflecting the importance of enrolling pharmacists in continuous learning system.

Assessment of drug-prescribing perception and practice among dental care providers: a cross-sectional Lebanese study

“…However, acknowledging their inherent risks, weak opioids such as codeine and tramadol were classified as controlled drugs and cannot be dispensed by pharmacists without a doctor’s prescription, including dentists. 25 , 26 Despite this restriction in Lebanon, local data from a pharmacist’s perspective expressed the need for better supervision on sales and better governmental regulations to limit possible misuse or abuse. 26 In addition to opioids, clinicians should acknowledge the toxicity of NSAIDs and their potential interactions and adverse effects, especially that, in Lebanon, these medications are available over-the-counter.…”

“…25 , 26 Despite this restriction in Lebanon, local data from a pharmacist’s perspective expressed the need for better supervision on sales and better governmental regulations to limit possible misuse or abuse. 26 In addition to opioids, clinicians should acknowledge the toxicity of NSAIDs and their potential interactions and adverse effects, especially that, in Lebanon, these medications are available over-the-counter. Therefore, dentists should advise their patients to avoid self-medication and should be extremely cautious when prescribing this class of analgesics in older patients, in patients with gastrointestinal problems, or taking aspirin, oral anticoagulants (vitamin K antagonists), or corticosteroids, due to the risk of gastric bleeding and peptic ulcer disease.…”

Community Pharmacists’ Perceptions towards the Misuse and Abuse of Pregabalin: A Cross-Sectional Study from Aseer Region, Saudi Arabia

“…No previous study has been conducted on community pharmacists' perceptions towards pregabalin misuse and abuse in Saudi Arabia; therefore, the survey was adopted from four previous studies conducted elsewhere [3,23,24,28]. The questionnaire consisted of 21 questions on 2 domains; Domain I: 10 questions related to demographics; Domain II: 11 questions on perception with open and closed questions related to community pharmacists' perceptions towards pregabalin misuse and abuse.…”

“…A study conducted in Jordan on community pharmacist's experiences of pregabalin misuse and abuse among their customers reveals that most participants (87.4%) reported cases of pregabalin abuse in their pharmacies [23]. Another study conducted in Lebanon reported that pharmacists might need to improve their knowledge concerning tramadol and gabapentinoids (α 2 δ ligands) [24]. Pregabalin was deemed a safe and effective medication for pain and helping with sleep in a Chinese study area at doses of 300-450 mg per day [25].…”

Dispensing patterns of drugs used for neuropathic pain and adherence to NeuPSIG guideline: an observational study

“…However, while the Ministry of Public Health continually inspects tramadol dispense records, no clear regulations to control gabapentinoids dispensing. That is, the latter may be dispensed by pharmacists without a prescription [13].…”