Gabapentinoid Use among Medicare Beneficiaries during the Post-Stroke Recovery Period

Area of Science:

• Geriatric Medicine
• Neurology
• Pharmacology

Background:

• Gabapentinoid prescribing trends are understudied in vulnerable populations like older stroke survivors.
• Characterizing gabapentinoid use in this demographic is crucial for understanding post-stroke care.

Purpose of the Study:

• To describe gabapentinoid initiation patterns among Medicare beneficiaries after acute ischemic stroke (AIS).
• To analyze trends and geographic variations in gabapentinoid prescribing post-stroke.

Main Methods:

• Analysis of claims data from a 20% sample of U.S. Medicare beneficiaries (≥65 years) hospitalized for AIS (2009-2022).
• Inclusion criteria: traditional Medicare enrollment, no prior stroke, discharged home or to inpatient facility (≤30 days).
• Outpatient gabapentinoid prescriptions within six months post-discharge were analyzed, standardized by age, destination, and modified Rankin Score.

Main Results:

• 4.9% of 153,728 eligible Medicare stroke survivors initiated gabapentinoids within six months post-discharge.
• Gabapentinoid initiation increased from 3.6% in 2009 to 5.8% in 2022.
• Significant geographic variation observed, with highest initiation in West South Central (6.0%) and lowest in New England (3.9%) divisions.

Conclusions:

• Gabapentinoid initiation among U.S. Medicare stroke survivors has risen between 2009 and 2022.
• Geographic disparities in gabapentinoid prescribing exist among stroke survivors in the U.S.