Trajectories of pregabalin use and their association with longitudinal changes in opioid and benzodiazepine use

Schaffer, Andrea L; Brett, Jonathan; Buckley, Nicholas A; Pearson, Sallie‐Anne

doi:10.1097/j.pain.0000000000002433

Cited by 5 publications

(4 citation statements)

References 45 publications

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“…These analyses may uncover if over time workers compensation populations are at increased risk of pregabalin overdoses, a characteristic noted more frequently associated with men. 11 30 Additionally, future analyses may investigate if co-prescribing gabapentinoids with other high-risk drugs like opioid analgesics and benzodiazepines, a triad of drugs that can have serious health consequences (eg, death, intentional or unintentional poisonings, hospitalisations), is a concern in the worker compensation population as it has been identified in the care seeing 39 and general population. 40…”

Section: Discussionmentioning

confidence: 99%

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

Mathieson,

Collie,

Maher

et al. 2024

Occup Environ Med

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ObjectivesThe increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017, and determine secular trends in, and factors associated with gabapentinoid use.MethodsWe analysed claim-level and service-level data from the Victorian workers’ compensation programme between 1 January 2010 and 31 December 2017 for workers with an accepted claim for a low back pain injury and who had programme-funded gabapentinoid dispensing. Secular trends were calculated as a proportion of gabapentinoid dispensings per year. Poisson, negative binomial and Cox hazards models were used to examine changes over time in incidence and time to first dispensing.ResultsOf the 17 689 low back pain claimants, one in seven (14.7%) were dispensed at least one gabapentinoid during the first 2 years (n=2608). The proportion of workers who were dispensed a gabapentinoid significantly increased over time (7.9% in 2010 to 18.7% in 2017), despite a reduction in the number of claimants dispensed pain-related medicines. Gabapentinoid dispensing was significantly associated with an opioid analgesic or anti-depressant dispensing claim, but not claimant-level characteristics. The time to first gabapentinoid dispensing significantly decreased over time from 311.9 days (SD 200.7) in 2010 to 148.2 days (SD 183.1) in 2017.ConclusionsThe proportion of claimants dispensed a gabapentinoid more than doubled in the period 2010–2017; and the time to first dispensing halved during this period.

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Section: Discussionmentioning

confidence: 99%

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

Mathieson,

Collie,

Maher

et al. 2024

Occup Environ Med

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“…12 This method allowed us to identify longitudinal clusters and summarize unknown complex patterns of medication use across a prolonged period of time and has been widely applied to clinical research, including drug utilization studies. [13][14][15]…”

Section: Why Does This Paper Matter?mentioning

confidence: 99%

“…Considering the length of the study period and the expected heterogeneity in medication use in this population, we performed a group‐based trajectory modeling (GBTM) analysis 12 . This method allowed us to identify longitudinal clusters and summarize unknown complex patterns of medication use across a prolonged period of time and has been widely applied to clinical research, including drug utilization studies 13–15 …”

Section: Introductionmentioning

confidence: 99%

Spousal bereavement and four‐year trajectories of medication use: A nationwide register‐based study in Swedish older adults

Maura,

Blotière,

Wastesson

et al. 2024

J American Geriatrics Society

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BackgroundMedication use around widowhood has been poorly described for most medication classes. Medication use patterns can reflect health consequences of spousal loss, as previously shown for psychotropic drugs.MethodsWe used data from nationwide health registers (2008–2020) to describe the patterns of use of dispensed medications in all widowed Swedes aged ≥65 years followed between 2 years before and 2 years after spousal death. All prescription drugs used by at least 5% of the cohort were considered according to their therapeutic subgroups (Anatomical Therapeutic Chemical [ATC] classification system 2nd level). We used group‐based trajectory models to cluster widowed individuals into up to 4 distinct longitudinal patterns of monthly medication use. We ranked the therapeutic subgroups with similar patterns according to their plausibility to reflect potential health effects of spousal loss, compared to those of psycholeptics (mainly anxiolytics, hypnotics) and psychoanaleptics (mainly antidepressants) as the references.ResultsFrom 212,111 widowed adults included (68% female and 70% aged ≥75 years), we observed a significant increasing trend in medication use, especially after spousal death, for 21 out of the 39 different therapeutic subgroups that were used by at least 5% (most represented pharmacological groups: cardiovascular system, nervous system, and alimentary tract and metabolism). This increasing trend often concerned only a small proportion of individuals, with varying magnitude and speed of change in medication use across therapeutic subgroups. The patterns of use of antiepileptics, laxatives, skin emollients/protectives, analgesics, and drugs for anemia, constipation, or peptic ulcers, were the closest to those of references, displaying the largest changes in use, and were therefore ranked as the most likely to reflect health effects of spousal loss.ConclusionOur results confirmed the increase in psychotropic medications' use in widowed older adults and identified several potential physical health effects of spousal loss that warrant further research.

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“…As with Oxycontin, pharmaceutical companies marketing gabapentinoids have paid millions in fines for misrepresenting their safety and misuse potential and for promoting prescribing for off‐label indications, inflating demand [11]. In the United States, gabapentinoids are now prescribed during one in four post‐surgical admissions, often in combination with opioids or other analgesics, putatively to reduce opioid consumption [12], despite limited evidence for effectiveness peri‐operatively [13] or of opioid‐sparing effects [14]. Much of the longer‐term off‐label prescribing of gabapentinoids is to treat chronic low back pain, increasing availability among a population already vulnerable to misuse, with increased risk of harms through multiple co‐prescribed sedative medications [15].…”

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confidence: 99%

Gabapentinoids: repeating mistakes of the past?

et al. 2022

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Trajectories of pregabalin use and their association with longitudinal changes in opioid and benzodiazepine use

Abstract: Supplemental Digital Content is Available in the Text.Among people initiating pregabalin, opioid use and the estimated daily opioid dose were higher postinitiation. Patterns of benzodiazepine use changed little after pregabalin initiation.

Cited by 5 publications

References 45 publications

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

Spousal bereavement and four‐year trajectories of medication use: A nationwide register‐based study in Swedish older adults

Gabapentinoids: repeating mistakes of the past?

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