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Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care.
Osteoarthritis Cartilage. 2019 10; 27(10):1437-1444.OC

Abstract

OBJECTIVE

To investigate trends in gabapentinoid prescribing in patients with osteoarthritis (OA).

METHODS

Patients aged 40 years and over with a new OA diagnosis recorded between 1995 and 2015 were identified in the Clinical Practice Research Datalink (CPRD) and followed to first prescription of gabapentin or pregabalin, or other censoring event. We estimated the crude and age-standardised annual incidence rates of gabapentinoid prescribing, stratified by patient age, sex, geographical region, and time since OA diagnosis, and the proportion of prescriptions attributable to OA, or to other conditions representing licensed and unlicensed indications for a gabapentinoid prescription.

RESULTS

Of 383,680 newly diagnosed OA cases, 35,031 were prescribed at least one gabapentinoid. Irrespective of indication, the annual age-standardised incidence rate of first gabapentinoid prescriptions rose from 1.6 [95% confidence interval (CI): 1.3, 2.0] per 1000 person-years in 2000, to 27.6 (26.7, 28.4) in 2015, a trend seen across all ages and not explained by length of follow-up. Rates were higher among women, younger patients, and in Northern Ireland, Scotland and the North of England. Approximately 9% of first prescriptions could be attributed to OA, a further 13% to comorbid licensed or unlicensed indications.

CONCLUSION

Gabapentinoid prescribing in patients with OA increased dramatically between 1995 and 2015. In most cases, diagnostic codes for licensed or unlicensed indications were absent. Gabapentinoid prescribing may be attributable to OA in a significant proportion but evidence for their effectiveness in OA is lacking. Further research to investigate clinical decision making around prescribing these expensive and potentially harmful medicines is recommended.

Authors+Show Affiliations

Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: t.appleyard@keele.ac.uk.Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: j.ashworth@keele.ac.uk.Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: j.bedson@keele.ac.uk.Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: d.yu@keele.ac.uk.Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: g.m.peat@keele.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31276819

Citation

Appleyard, T, et al. "Trends in Gabapentinoid Prescribing in Patients With Osteoarthritis: a United Kingdom National Cohort Study in Primary Care." Osteoarthritis and Cartilage, vol. 27, no. 10, 2019, pp. 1437-1444.
Appleyard T, Ashworth J, Bedson J, et al. Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care. Osteoarthritis Cartilage. 2019;27(10):1437-1444.
Appleyard, T., Ashworth, J., Bedson, J., Yu, D., & Peat, G. (2019). Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care. Osteoarthritis and Cartilage, 27(10), 1437-1444. https://doi.org/10.1016/j.joca.2019.06.008
Appleyard T, et al. Trends in Gabapentinoid Prescribing in Patients With Osteoarthritis: a United Kingdom National Cohort Study in Primary Care. Osteoarthritis Cartilage. 2019;27(10):1437-1444. PubMed PMID: 31276819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care. AU - Appleyard,T, AU - Ashworth,J, AU - Bedson,J, AU - Yu,D, AU - Peat,G, Y1 - 2019/07/02/ PY - 2019/01/11/received PY - 2019/06/03/revised PY - 2019/06/17/accepted PY - 2019/7/6/pubmed PY - 2020/9/18/medline PY - 2019/7/6/entrez KW - Epidemiology KW - Gabapentin KW - Gabapentinoid KW - Osteoarthritis KW - Pregabalin SP - 1437 EP - 1444 JF - Osteoarthritis and cartilage JO - Osteoarthritis Cartilage VL - 27 IS - 10 N2 - OBJECTIVE: To investigate trends in gabapentinoid prescribing in patients with osteoarthritis (OA). METHODS: Patients aged 40 years and over with a new OA diagnosis recorded between 1995 and 2015 were identified in the Clinical Practice Research Datalink (CPRD) and followed to first prescription of gabapentin or pregabalin, or other censoring event. We estimated the crude and age-standardised annual incidence rates of gabapentinoid prescribing, stratified by patient age, sex, geographical region, and time since OA diagnosis, and the proportion of prescriptions attributable to OA, or to other conditions representing licensed and unlicensed indications for a gabapentinoid prescription. RESULTS: Of 383,680 newly diagnosed OA cases, 35,031 were prescribed at least one gabapentinoid. Irrespective of indication, the annual age-standardised incidence rate of first gabapentinoid prescriptions rose from 1.6 [95% confidence interval (CI): 1.3, 2.0] per 1000 person-years in 2000, to 27.6 (26.7, 28.4) in 2015, a trend seen across all ages and not explained by length of follow-up. Rates were higher among women, younger patients, and in Northern Ireland, Scotland and the North of England. Approximately 9% of first prescriptions could be attributed to OA, a further 13% to comorbid licensed or unlicensed indications. CONCLUSION: Gabapentinoid prescribing in patients with OA increased dramatically between 1995 and 2015. In most cases, diagnostic codes for licensed or unlicensed indications were absent. Gabapentinoid prescribing may be attributable to OA in a significant proportion but evidence for their effectiveness in OA is lacking. Further research to investigate clinical decision making around prescribing these expensive and potentially harmful medicines is recommended. SN - 1522-9653 UR - https://www.unboundmedicine.com/medline/citation/31276819/Trends_in_gabapentinoid_prescribing_in_patients_with_osteoarthritis:_a_United_Kingdom_national_cohort_study_in_primary_care_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1063-4584(19)31112-4 DB - PRIME DP - Unbound Medicine ER -