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