Ashworth Julie, Bajpai Ram, Muller Sara, Bailey James, Helliwell Toby, Harrisson Sarah A, Whittle Rebecca, Mallen Christian D
School of Medicine, Keele University, Staffordshire, United Kingdom.
Midlands Partnership NHS Foundation Trust, Staffordshire, United Kingdom.
Lancet Reg Health Eur. 2023 Feb 13;27:100579. doi: 10.1016/j.lanepe.2022.100579. eCollection 2023 Apr.
The UK government reclassified gabapentin and pregabalin as 'controlled drugs' from April 2019. This study aimed to describe the trends in gabapentinoid prescribing before and immediately after reclassification, in the UK Clinical Practice Research Datalink, an electronic primary care health record broadly representative of the UK.
Separately for gabapentin and pregabalin, we calculated annual incident and prevalent prescribing rates from year of UK approval (April 1997 and 2004 respectively) to September 2019, and monthly incident and prevalent prescribing rates (October 2017-September 2019). Significant changes in temporal trends were determined using joinpoint regression. We also described potential prescribing indications, prior pain-related prescribing, and co-prescribing with potentially interacting medicines.
Incident gabapentin prescribing increased annually, peaking in 2016-17, at 625/100,000 patient years before falling steadily to 2019. Incident pregabalin prescribing peaked at 329/100,000 patient years in 2017-18 and did not fall significantly until 2019. Prevalent gabapentin and pregabalin prescribing increased annually to 2017-18 and 2018-19 respectively, before plateauing. Gabapentinoids were commonly co-prescribed with opioids (60%), antidepressants (52%), benzodiazepines (19%), and Z-drugs (10%).
Following a dramatic rise, incident gabapentinoid prescribing has started to fall but the specific impact of reclassification on prescribing rates remains unclear. Limited change in prevalent gabapentinoid prescribing during the 6 months following their reclassification as controlled drugs suggests little immediate impact on continued gabapentinoid prescribing for existing users.
National Institute for Health and Care Research (NIHR) Research for Patient Benefit Programme. NIHR Applied Research Collaboration West Midlands. NIHR School for Primary Care Research.
英国政府自2019年4月起将加巴喷丁和普瑞巴林重新归类为“管制药物”。本研究旨在描述在英国临床实践研究数据链（一个广泛代表英国的电子基层医疗健康记录）中，重新归类之前及之后即刻的加巴喷丁类药物处方开具趋势。
分别针对加巴喷丁和普瑞巴林，我们计算了从英国批准年份（分别为1997年4月和2004年）至2019年9月的年度新发和现患处方率，以及月度新发和现患处方率（2017年10月至2019年9月）。使用连接点回归确定时间趋势的显著变化。我们还描述了潜在的处方指征；既往与疼痛相关的处方开具情况；以及与可能相互作用药物的联合处方情况。
加巴喷丁的新发处方量逐年增加，在2016 - 2017年达到峰值，为每10万患者年625例，随后稳步下降至2019年。普瑞巴林的新发处方量在2017 - 2018年达到峰值，为每10万患者年329例，直到2019年才显著下降。加巴喷丁和普瑞巴林的现患处方量分别在2017 - 2018年和2018 - 2019年逐年增加，之后趋于平稳。加巴喷丁类药物常与阿片类药物（60%）、抗抑郁药（52%）、苯二氮䓬类药物（19%）和Z类药物（10%）联合处方。
在急剧上升之后，加巴喷丁类药物的新发处方量已开始下降，但重新归类对处方率的具体影响仍不清楚。在它们被重新归类为管制药物后的6个月内，加巴喷丁类药物现患处方量变化有限，这表明对现有使用者继续开具加巴喷丁类药物的处方几乎没有立即产生影响。
国家健康与照护研究所（NIHR）患者受益研究计划。NIHR西米德兰兹应用研究合作组织。NIHR初级保健研究学院。
