Pain And The Use Of Gabapentinoids In German Nursing Home Residents - Results From An Analysis Based On Statutory...

Area of Science:

• Geriatric Medicine
• Pharmacology
• Public Health

Background:

• Gabapentinoids (gabapentin, pregabalin) are increasingly used psychoactive medications.
• Psychotropic drug prescribing is often inappropriate in the elderly.
• The study focuses on gabapentinoid use in German nursing home residents.

Purpose of the Study:

• Determine the frequency of gabapentinoid prescribing in nursing home residents.
• Identify common indications for on- and off-label gabapentinoid use.
• Analyze patient and prescriber characteristics associated with gabapentinoid use.

Main Methods:

• Analysis of a large German statutory health insurance database.
• Inclusion of residents aged 65+ admitted to nursing homes between 2010-2014.
• Determination of prescription indications, co-medications, and patient/prescriber factors.

Main Results:

• 7.5% of residents received gabapentinoids; 4.0% initiated treatment (66.3% pregabalin).
• On-label use was 57.4% (predominantly neuropathic pain); 84.7% of off-label use was for other painful conditions.
• General practitioners initiated most prescriptions (64.5%); 46% received concomitant opioids; 27.5% were single prescriptions.

Conclusions:

• Gabapentinoids are frequently used in nursing home residents, often for pain.
• Co-prescribing with opioids and other psychotropics may target pain or behavioral issues in dementia.
• More research is crucial to understand gabapentinoid prescribing in the elderly due to marketing, side effects, and efficacy concerns.