Pregabalin prescribing patterns in Australian general practice, 2012-2018: a cross-sectional study

Area of Science:

• Pharmacovigilance
• General Practice Research
• Pain Management

Background:

• Pregabalin was subsidized in Australia in 2013 for neuropathic pain.
• Since then, pregabalin prescribing and associated harm have risen.
• Concerns exist regarding off-label prescribing for indications lacking efficacy evidence.

Purpose of the Study:

• To characterize pregabalin prescribing patterns within Australian general practice.
• To analyze the indications for pregabalin use and co-prescribing with other central nervous system depressants.

Main Methods:

• A cross-sectional study utilizing the MedicineInsight database.
• Involved data from 445 Australian general practice sites between March 2012 and February 2018.
• Analyzed prescription proportions, pain condition prevalence, and concurrent opioid/benzodiazepine prescribing.

Main Results:

• Pregabalin prescriptions increased from 13 to 104 per 10,000 between 2012-13 and 2017-18.
• Of 114,123 patients prescribed pregabalin, only 49.7% had a neuropathic pain diagnosis.
• Significant proportions were prescribed pregabalin for back problems (43.5%), chronic pain (8.8%), or with no pain diagnosis (26.4%).
• Same-day prescribing with opioids occurred in 38.1% and with benzodiazepines in 13.1% of patients.

Conclusions:

• A substantial rise in pregabalin prescribing in Australian general practice was observed.
• Less than half of patients prescribed pregabalin had a recorded diagnosis of neuropathic pain, the sole approved indication.
• High rates of concurrent prescribing with opioids and benzodiazepines may elevate patient risk.