Study, Nov/20: Pregabalin prescribing patterns in Australian general practice

The full title of this Australian study is "Pregabalin prescribing patterns in Australian general practice, 2012 to 2018 ".

https://pubmed.ncbi.nlm.nih.gov/33172853/

Abstract

Background: Pregabalin prescribing and harms have been increasing in Australia, with concerns it is prescribed for indications with little evidence of efficacy. In 2013, it was subsidised by Australia's Pharmaceutical Benefits Scheme for neuropathic pain.

Aim: To describe pregabalin prescribing in Australian general practice.

Design/setting: A cross-sectional study of patients attending 445 general practice sites in the national MedicineInsight database from March 2012 to February 2018.

Method: We calculated the proportion of prescriptions for pregabalin per year; the prevalence of pain conditions in patients prescribed pregabalin; and same-day prescribing of pregabalin with opioids or benzodiazepines.

Results: Prescribing increased from 13/10,000 to 104/10,000 prescriptions between 2012/13 and 2017/18. We identified 1,891,623 patients of whom 114,123 (6.0%) were prescribed pregabalin; 49.7% (n=56,772) had a recorded diagnosis of neuropathic pain. Among people without a recorded diagnosis of neuropathic pain, 43.5% (n=24,927) had a diagnosis of back problems, 8.8% (n=5,073) chronic pain, and 26.4% (n=30,146) no pain diagnosis. Pregabalin was prescribed the same day as an opioid to 38.1% of patients (95%CI 37.1%-39.1%) and a benzodiazepine to 13.1% of patients (95%CI 12.5%-13.7%). Patients with chronic pain had the highest rate of same-day prescribing of pregabalin with an opioid (70.4%, 95%CI 68.9%-71.9%) or a benzodiazepine (25.8%, 95%CI 24.2%-27.4%) Conclusion: We identified substantial increases in pregabalin prescribing in Australian general practice, but only half of patients had a neuropathic pain diagnosis recorded, the only approved indication for subsidy. High rates of same-day prescribing with opioids and benzodiazepines may put patients at increased risk of harm.