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Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center.
Hosp Pediatr. 2021 08; 11(8):909-914.HP

Abstract

OBJECTIVES

Analgesic medications are commonly prescribed in pediatrics, with prescribing practices frequently extrapolated from adult trials. Gabapentinoids (gabapentin and pregabalin) are widely used as analgesics but are labeled in pediatrics only for epilepsy. We aim to (1) define trends in pediatric gabapentinoid prescribing (label and off-label) over 7 years, and (2) evaluate use in chronic pain clinic (CPC) patients during 2018.

METHODS

Retrospective data from a tertiary-care pediatric hospital were collected between 2013 and 2019. Annual numbers of gabapentinoid prescriptions were stratified by prescriber specialty. Additional information about gabapentinoid prescribing in the CPC was manually collected from initial clinic notes in 2018.

RESULTS

There were 15 808 outpatient prescriptions for gabapentinoids among 5172 patients over 7 years. Of these, 93% were gabapentin and 7% were pregabalin. Numbers of patients receiving gabapentin and pregabalin prescriptions increased by 1.4- and 1.3-fold, respectively, between 2013 and 2019. Few prescriptions were done for patients with a previous epilepsy diagnosis (in 2019, 16% for gabapentin and 13% for pregabalin). Approximately 28% of 650 CPC new patients were prescribed gabapentin or pregabalin before referral. Among those, 44% had discontinued the medication because of adverse events (35%), inefficacy (46%), or both (5%). Most side effects reported were mild to moderate. Diagnoses at first visit were diverse, not limited to neuropathic pain conditions, and did not differ between patients receiving or not receiving gabapentinoid prescriptions.

CONCLUSIONS

In our hospital, gabapentinoids are commonly prescribed off-label for diverse indications, including chronic pain. Future research is needed to evaluate gabapentinoid efficacy in these indications.

Authors+Show Affiliations

Department of Anesthesiology, Critical Care and Pain Medicine and carolina.donadorincon@childrens.harvard.edu. Departments of Anaesthesia and.Department of Anesthesiology, Critical Care and Pain Medicine and.Department of Anesthesiology, Critical Care and Pain Medicine and. Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Department of Anesthesiology, Critical Care and Pain Medicine and. Departments of Anaesthesia and.Pediatric Therapeutics and Regulatory Science Initiative, Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts. Pediatrics, Harvard Medicine School, Harvard University, Boston, Massachusetts; and.Department of Anesthesiology, Critical Care and Pain Medicine and. Departments of Anaesthesia and.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34257145

Citation

Donado, Carolina, et al. "Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center." Hospital Pediatrics, vol. 11, no. 8, 2021, pp. 909-914.
Donado C, Nedeljkovic K, Wangnamthip S, et al. Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center. Hosp Pediatr. 2021;11(8):909-914.
Donado, C., Nedeljkovic, K., Wangnamthip, S., Solodiuk, J. C., Bourgeois, F. T., & Berde, C. B. (2021). Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center. Hospital Pediatrics, 11(8), 909-914. https://doi.org/10.1542/hpeds.2020-003582
Donado C, et al. Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center. Hosp Pediatr. 2021;11(8):909-914. PubMed PMID: 34257145.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in Gabapentin and Pregabalin Prescribing in a Tertiary Pediatric Medical Center. AU - Donado,Carolina, AU - Nedeljkovic,Kristina, AU - Wangnamthip,Suratsawadee, AU - Solodiuk,Jean C, AU - Bourgeois,Florence T, AU - Berde,Charles B, Y1 - 2021/07/13/ PY - 2021/7/15/pubmed PY - 2021/10/30/medline PY - 2021/7/14/entrez SP - 909 EP - 914 JF - Hospital pediatrics JO - Hosp Pediatr VL - 11 IS - 8 N2 - OBJECTIVES: Analgesic medications are commonly prescribed in pediatrics, with prescribing practices frequently extrapolated from adult trials. Gabapentinoids (gabapentin and pregabalin) are widely used as analgesics but are labeled in pediatrics only for epilepsy. We aim to (1) define trends in pediatric gabapentinoid prescribing (label and off-label) over 7 years, and (2) evaluate use in chronic pain clinic (CPC) patients during 2018. METHODS: Retrospective data from a tertiary-care pediatric hospital were collected between 2013 and 2019. Annual numbers of gabapentinoid prescriptions were stratified by prescriber specialty. Additional information about gabapentinoid prescribing in the CPC was manually collected from initial clinic notes in 2018. RESULTS: There were 15 808 outpatient prescriptions for gabapentinoids among 5172 patients over 7 years. Of these, 93% were gabapentin and 7% were pregabalin. Numbers of patients receiving gabapentin and pregabalin prescriptions increased by 1.4- and 1.3-fold, respectively, between 2013 and 2019. Few prescriptions were done for patients with a previous epilepsy diagnosis (in 2019, 16% for gabapentin and 13% for pregabalin). Approximately 28% of 650 CPC new patients were prescribed gabapentin or pregabalin before referral. Among those, 44% had discontinued the medication because of adverse events (35%), inefficacy (46%), or both (5%). Most side effects reported were mild to moderate. Diagnoses at first visit were diverse, not limited to neuropathic pain conditions, and did not differ between patients receiving or not receiving gabapentinoid prescriptions. CONCLUSIONS: In our hospital, gabapentinoids are commonly prescribed off-label for diverse indications, including chronic pain. Future research is needed to evaluate gabapentinoid efficacy in these indications. SN - 2154-1671 UR - https://www.unboundmedicine.com/medline/citation/34257145/Trends_in_Gabapentin_and_Pregabalin_Prescribing_in_a_Tertiary_Pediatric_Medical_Center_ L2 - https://publications.aap.org/hospitalpediatrics/article-lookup/doi/10.1542/hpeds.2020-003582 DB - PRIME DP - Unbound Medicine ER -