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

Abstract

Background Neuropathic pain is a common chronic ailment that can be challenging to treat because of the heterogeneity of its etiologies, symptoms, and underlying mechanisms. Drugs to treat neuropathic pain are highly prescribed; however, limited data exist on the rates and patterns of dispensing in Lebanon. This study was conducted to assess the patterns of dispensing neuropathic pain drugs and adherence to NeuPSIG guideline in the Lebanese adult population. An observational study was conducted at 30 community pharmacies over 10 months. Adults presenting to the community pharmacy with a prescription of at least one pain medication and diagnosed with a neuropathic pain disorder were interviewed using a questionnaire that included demographic characteristics of patients, comorbidities, neuropathic pain disorder type, physicians’ specialty, and the class and number of prescribed medications. Results A total of 360 patients diagnosed with painful neuropathy were enrolled in our study. The mean patients’ age was 50.2 years. Guideline-recommended first-line agents (serotonin–norepinephrine reuptake inhibitors, tricyclic antidepressants, and gabapentinoids) were prescribed to 278 patients (77.2%), with pregabalin being the most used drug (60.5%), nonsteroidal anti‐inflammatory drugs (46.8%), opioids (15.8%), and topical agents (5.5%). Combination treatment for neuropathic pain was prescribed to 78.3% of patients. Conclusions In Lebanon, neuropathic pain management comply with the international NeuPSIG guideline. Pregabalin is the most commonly used drug, and combination treatments are usually needed to alleviate neuropathic pain.

Pregabalin versus Gabapentin Efficacy in the Management of Neuropathic Pain Associated with Failed Back Surgery Syndrome

“…The European Federations of Neurological Societies have recommended gabapentinoids and tricyclic antidepressants as first-line medicines for neuropathic pain except for trigeminal neuralgia [ 3 ], with clinical evidence for the efficacy of gabapentin monotherapy in reducing pain plus functional recovery [ 5 ]. The foremost analgesics used for neuropathic pain are those which act by lessening action potentials in A and C fibers by blocking voltage-dependent ion channels or hindering pain transmission along the spine [ 11 ].…”