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Concurrent Opioid–Gabapentin Prescribing Patterns

Despite questionable efficacy and likelihood of producing a euphoric state, opioid analgesics (OAs) were prescribed concurrently with gabapentin (OACGs) with increasing frequency between 2006 and 2018 in a national pharmacy database, researchers report. “Better understanding factors associated with these trends, and to what extent they may be mitigated or exacerbated by prescribing policies and/or physician education, will facilitate efforts to address this increasingly common and potentially dangerous clinical practice,” the researchers conclude.

Data for about 90% of prescriptions filled at community pharmacies were obtained for 2006 through 2018 in the IQVIA Real World Data Longitudinal Prescription Data files. OACGs were defined as any overlap between fill dates and the last day of supply (or refills). The frequency of coprescribing climbed during this time, and nearly one-fifth of OACGs involved OAs and gabapentin starting during the same week. The authors report these results: “Overlapping OA and gabapentin episodes grew between 2006 and 2018 among all prescribers and patient groups, but were consistently most common among (1) pain specialist prescribers (19.2% compared with 4.2% among all other specialties) (2) female patients (5.2% compared with 4.2% among male patients); (3) patients 66 years or older (8.0% compared with 3.9% among all other age groups); (4) patients residing in rural counties (5.8% compared with 4.6% in urban counties); (5) patients residing in counties with the highest quartiles of non-Hispanic White population (6.2% compared with 4.7% in all other counties; and (6) patients residing in counties with the highest quartile of poverty (5.5% compared with 4.6% in all other counties).”

Source: JAMA Internal Medicine