Suppr超能文献

2009-2016 年美国商业保险成年人群中加巴喷丁处方趋势。

Trends in Gabapentin Prescribing in a Commercially Insured U.S. Adult Population, 2009-2016.

机构信息

Department of Health Policy, Management, and Leadership, West Virginia University School of Public Health, Morgantown.

Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, Lexington.

出版信息

J Manag Care Spec Pharm. 2020 Mar;26(3):246-252. doi: 10.18553/jmcp.2020.26.3.246.

Abstract

BACKGROUND

Gabapentin is prescribed for a variety of conditions and is often used off label. It is important to understand the prevalence of gabapentin prescribing and the characteristics of individuals who are prescribed gabapentin, given increasing concern regarding its potential for misuse.

OBJECTIVES

To (a) examine state- and region-level prevalence and trends in gabapentin prescribing from 2009 to 2016 and (b) characterize demographic and clinical characteristics of individuals prescribed gabapentin in a nationwide population of commercially insured adults.

METHODS

This retrospective, longitudinal study examined trends in gabapentin prescribing from 2009 to 2016. The study population included individuals aged 18-64 years who were enrolled in a commercial insurance plan at any point from 2009 to 2016. Individuals who were prescribed gabapentin were defined as beneficiaries with at least 1 gabapentin prescription claim in a calendar year (CY). A cross-sectional descriptive analysis was performed to examine differences in demographic and clinical characteristics of individuals prescribed or not prescribed gabapentin in CY 2016.

RESULTS

The prevalence of gabapentin prescribing nearly doubled from 2009 to 2016. During this time, gabapentin prescribing increased in every state (range: 44%-179%). State-specific prevalence rates in 2016 varied from 12.7 to 43.9 per 1,000 beneficiaries. Overall, 2.7% of beneficiaries filled ≥ 1 gabapentin prescription in 2016. Individuals prescribed gabapentin were more likely to fill opioid prescriptions (60.8% vs. 16.5%, < 0.01); reside in the South (53.7% vs. 47%, < 0.01); be female (62.5% vs. 52.3%, < 0.01); and be aged 55-64 years (41.7% vs. 21.2%, < 0.01) compared with the comparator. Individuals who were prescribed gabapentin also had significantly higher rates of seizure disorders, neuropathic pain, mental health disorders, substance use disorders, and diabetes.

CONCLUSIONS

The prevalence of gabapentin prescribing among a U.S. privately insured population has increased steadily in recent years. Additional research should examine coprescribing of gabapentin in the context of the opioid epidemic.

DISCLOSURES

The project described in this study was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. This study was also partially supported by grant number 2017-PM-BX-K026 (Data-Driven Responses to Prescription Drug Misuse in Kentucky) awarded by the Bureau of Justice Assistance. Viewpoints or opinions in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice or the official views of the NIH. The authors do not have any conflicts of interest to report. Portions of this study have been previously presented in poster presentations at the 2019 Academy Health Annual Research Meeting; June 2-4, 2019; Washington, DC, and the 2019 University of Kentucky Substance Use Research Day; March 3, 2019; Lexington, KY.

摘要

背景

加巴喷丁被用于治疗多种疾病,且经常被超适应证使用。了解加巴喷丁的使用情况及其在人群中的特征十分重要,因为人们越来越担心其可能被滥用。

目的

(a)从 2009 年至 2016 年,评估州和地区层面加巴喷丁的使用情况和趋势;(b)描述在全国范围内商业保险的成年人中,使用加巴喷丁的个体的人口统计学和临床特征。

方法

本回顾性纵向研究评估了 2009 年至 2016 年期间加巴喷丁的使用趋势。研究人群包括 2009 年至 2016 年期间任何时候参加商业保险计划的 18-64 岁个体。在某一年度(日历年度,CY)至少有 1 次加巴喷丁处方记录的个体被定义为使用加巴喷丁的受益人群。对 2016 年 CY 未使用或使用加巴喷丁的个体进行人口统计学和临床特征的描述性比较。

结果

从 2009 年至 2016 年,加巴喷丁的使用情况几乎翻了一番。在此期间,每个州的加巴喷丁处方量均有所增加(范围:44%-179%)。2016 年各州的特定患病率从每 1000 名受益人群中 12.7 例至 43.9 例不等。总体而言,2016 年有 2.7%的受益人群使用了至少 1 次加巴喷丁。与对照组相比,使用加巴喷丁的个体更有可能开具阿片类药物处方(60.8% vs. 16.5%,<0.01);居住在南部(53.7% vs. 47%,<0.01);为女性(62.5% vs. 52.3%,<0.01);年龄在 55-64 岁(41.7% vs. 21.2%,<0.01)。与对照组相比,使用加巴喷丁的个体患有癫痫、神经病理性疼痛、精神健康障碍、物质使用障碍和糖尿病的比例更高。

结论

近年来,美国私人保险人群中使用加巴喷丁的情况稳步增加。需要进一步研究阿片类药物流行的背景下加巴喷丁的联合使用情况。

披露

本研究项目得到美国国立卫生研究院国家转化医学科学中心授予的 UL1TR001998 号资助。该研究还得到美国司法部执法援助局授予的 2017-PM-BX-K026 号拨款(肯塔基州应对处方药滥用的基于数据的应对措施)的部分支持。本文观点或意见仅代表作者本人,不一定代表美国司法部或美国国立卫生研究院的官方立场。作者没有任何利益冲突需要申报。本研究的部分内容以前曾以海报形式在 2019 年美国学术健康年会(2019 年 6 月 2 日至 4 日,华盛顿特区)和 2019 年肯塔基大学药物使用研究日(2019 年 3 月 3 日,列克星敦,肯塔基州)上进行过介绍。

相似文献

1
Trends in Gabapentin Prescribing in a Commercially Insured U.S. Adult Population, 2009-2016.
J Manag Care Spec Pharm. 2020 Mar;26(3):246-252. doi: 10.18553/jmcp.2020.26.3.246.
2
Controlled Substance Prescribing Patterns--Prescription Behavior Surveillance System, Eight States, 2013.
MMWR Surveill Summ. 2015 Oct 16;64(9):1-14. doi: 10.15585/mmwr.ss6409a1.
4
Opioid prescribing rates from the emergency department: Down but not out.
Drug Alcohol Depend. 2019 Dec 1;205:107636. doi: 10.1016/j.drugalcdep.2019.107636. Epub 2019 Oct 17.
7
Unfilled Prescriptions of Medicare Beneficiaries: Prevalence, Reasons, and Types of Medicines Prescribed.
J Manag Care Spec Pharm. 2020 Aug;26(8):935-942. doi: 10.18553/jmcp.2020.26.8.935.
8
Time trends and prescribing patterns of opioid drugs in UK primary care patients with non-cancer pain: A retrospective cohort study.
PLoS Med. 2020 Oct 15;17(10):e1003270. doi: 10.1371/journal.pmed.1003270. eCollection 2020 Oct.
9
Trends in gabapentinoid prescribing, co-prescribing of opioids and benzodiazepines, and associated deaths in Scotland.
Br J Anaesth. 2020 Aug;125(2):159-167. doi: 10.1016/j.bja.2020.05.017. Epub 2020 Jun 19.

引用本文的文献

1
Gabapentinoid Use among Medicare Beneficiaries during the Post-Stroke Recovery Period.
medRxiv. 2025 Aug 11:2025.08.06.25333178. doi: 10.1101/2025.08.06.25333178.
4
Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications.
Arthrosc Sports Med Rehabil. 2024 Oct 22;7(1):101030. doi: 10.1016/j.asmr.2024.101030. eCollection 2025 Feb.
5
Psychotropic medications: a descriptive study of prescription trends in Tabriz, Iran, 2021-2022.
BMC Psychiatry. 2025 Jan 3;25(1):10. doi: 10.1186/s12888-024-06451-2.
7
Prescribing Patterns and Off-Label Use of Gabapentinoid Agents at Dhulikhel Hospital, Nepal: A Cross-Sectional Study.
J Pain Res. 2024 Dec 18;17:4377-4391. doi: 10.2147/JPR.S493542. eCollection 2024.
9
Pilot RCT comparing low-dose naltrexone, gabapentin and placebo to reduce pain among people with HIV with alcohol problems.
PLoS One. 2024 Feb 26;19(2):e0297948. doi: 10.1371/journal.pone.0297948. eCollection 2024.
10
Characterizing Gabapentinoid Use Among Patients With Isolated Low Back Pain.
Global Spine J. 2025 Mar;15(2):1106-1112. doi: 10.1177/21925682231224390. Epub 2024 Jan 25.

本文引用的文献

1
Gabapentin-related Deaths: Patterns of Abuse and Postmortem Levels.
J Forensic Sci. 2019 Jul;64(4):1105-1111. doi: 10.1111/1556-4029.14021. Epub 2019 Feb 7.
3
Gabapentin for Off-Label Use: Evidence-Based or Cause for Concern?
Subst Abuse. 2018 Sep 23;12:1178221818801311. doi: 10.1177/1178221818801311. eCollection 2018.
4
Gabapentin use, abuse, and the US opioid epidemic: the case for reclassification as a controlled substance and the need for pharmacovigilance.
Risk Manag Healthc Policy. 2018 Aug 17;11:109-116. doi: 10.2147/RMHP.S168504. eCollection 2018.
5
Prevalence of gabapentin in drug overdose postmortem toxicology testing results.
Drug Alcohol Depend. 2018 May 1;186:80-85. doi: 10.1016/j.drugalcdep.2018.01.018. Epub 2018 Mar 10.
6
Gabapentin for Chronic Neuropathic Pain.
JAMA. 2018 Feb 27;319(8):818-819. doi: 10.1001/jama.2017.21547.
7
Gabapentinoid Use in the United States 2002 Through 2015.
JAMA Intern Med. 2018 Feb 1;178(2):292-294. doi: 10.1001/jamainternmed.2017.7856.
8
A qualitative analysis of gabapentin misuse and diversion among people who use drugs in Appalachian Kentucky.
Psychol Addict Behav. 2018 Feb;32(1):115-121. doi: 10.1037/adb0000337. Epub 2017 Dec 14.
9
Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study.
PLoS Med. 2017 Oct 3;14(10):e1002396. doi: 10.1371/journal.pmed.1002396. eCollection 2017 Oct.
10
Gabapentin and Pregabalin for Pain - Is Increased Prescribing a Cause for Concern?
N Engl J Med. 2017 Aug 3;377(5):411-414. doi: 10.1056/NEJMp1704633.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验