Investigating the prescribing trajectory and geographical drug utilisation patterns of gabapentinoids in primary care in England: An ecological study

Abstract

This study aimed to investigate the prescribing trajectory, geographical variation and population factors, including socioeconomic status (SES), related to prescribing gabapentinoids in primary care in England.

Clinical Outcome Data of First Cohort of Chronic Pain Patients Treated With Cannabis‐Based Sublingual Oils in the United Kingdom: Analysis From the UK Medical Cannabis Registry

“…Nonsteroidal anti‐inflammatory drugs, which are commonly prescribed in the setting of musculoskeletal pain, similarly have an unclear role in chronic pain considering their association with gastrointestinal, cardiovascular, and renal adverse events 15,16 . Gabapentinoids, originally developed for the treatment of epilepsy, have been used with increased frequency off‐label for the treatment of chronic pain, partially driven by a desire to find a safer alternative to opioids 17,18 . However, similar to opioids and nonsteroidal anti‐inflammatory drugs, there is a paucity of evidence to support its current breadth of use in clinical practice, in addition to growing evidence of associated harms with chronic use, subversion, and abuse 18–20 …”

“…15,16 Gabapentinoids, originally developed for the treatment of epilepsy, have been used with increased frequency off-label for the treatment of chronic pain, partially driven by a desire to find a safer alternative to opioids. 17,18 However, similar to opioids and nonsteroidal anti-inflammatory drugs, there is a paucity of evidence to support its current breadth of use in clinical practice, in addition to growing evidence of associated harms with chronic use, subversion, and abuse. [18][19][20] In view of the challenges in managing chronic pain, there is growing interest in the endocannabinoid system as a drug target due to its role in modulating central and peripheral pain processes.…”

Geographic Variation in the Use of Gabapentinoids and Opioids for Pain in a Commercially Insured Adult Population in the United States

“…Our finding relating to gender and gabapentinoid use was consistent with some, 38–40 but not all studies. 35 One UK study found that the higher the proportions of women in a general practice region, the lower the use of gabapentinoids. 35 This contradicts our finding; however, the discrepancy was likely caused by the differences in handling aggregated data and that their study population may have been different from a US commercially insured population.…”

“… 35 One UK study found that the higher the proportions of women in a general practice region, the lower the use of gabapentinoids. 35 This contradicts our finding; however, the discrepancy was likely caused by the differences in handling aggregated data and that their study population may have been different from a US commercially insured population. Furthermore, there may be an overlap of geographic variations in the analgesic regimens explained by disparities in demographic profiles and prevalence of painful conditions, for example, an aging population would likely have higher prevalence of painful comorbidities.…”

The importance of non-fatal overdose in reducing drug related deaths characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service

“…The source of these drugs is less certain than for etizolam but diverted prescription sources seems at least partly responsible given the increasing prescribing patterns of these drugs generally. 6,7 However, we also know that people who use drugs experience chronic pain from a range of injuries so may be prescribed these themselves. The reported implications of strong and weak prescribed (or over the counter) analgesics in overdose events described in the paper are relatively small in this sample with just 1.26 and 2.15%, respectively, reported.…”