Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 23;5(1):bjgpopen20X101120.
doi: 10.3399/bjgpopen20X101120. Print 2021 Jan.

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

Andrea L Schaffer  1   2 , Doreen Busingye  2 , Kendal Chidwick  2 , Jonathan Brett  3 , Suzanne Blogg  2
Affiliations

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

Andrea L Schaffer et al. BJGP Open. .

Abstract

Background: In 2013 pregabalin was subsidised by Australia's Pharmaceutical Benefits Scheme (PBS) for neuropathic pain. Since the subsidy, pregabalin prescribing has been increasing in Australia and so has related harm. There are concerns it is being prescribed for indications other than neuropathic pain, which have little evidence of efficacy.

Aim: To describe pregabalin prescribing in Australian general practice.

Design & setting: A cross-sectional study of patients attending 445 general practice sites in the national MedicineInsight database from March 2012-February 2018.

Method: The following aspects were calculated: the proportion of prescriptions that were for pregabalin per year; the prevalence of pain conditions in patients prescribed pregabalin; and same-day prescribing of pregabalin with opioids or benzodiazepines.

Results: Prescribing increased from 13 per 10 000 to 104 per 10 000 prescriptions between 2012-2013 and 2017-2018. A total of 1 891 623 patients were identified of whom 114 123 (6.0%) were prescribed pregabalin; 49.7% (n = 56 772) had a recorded diagnosis of neuropathic pain. Among people prescribed pregabalin without a recorded diagnosis of neuropathic pain, 43.5% (n = 24 927) had a diagnosis of back problems, 8.8% (n = 5073) chronic pain, and 26.4% (n = 30 146) had no pain diagnosis. Pregabalin was prescribed the same day as an opioid to 38.1% of patients (95% confidence interval [CI] = 37.1% to 39.1%) and a benzodiazepine to 13.1% of patients (95% CI = 12.5% to 13.7%). Patients with a diagnosis of chronic pain had the highest rate of same-day prescribing of pregabalin with an opioid (70.4%, 95% CI = 68.9% to 71.9%) or a benzodiazepine (25.8%, 95% CI = 24.2% to 27.4%) CONCLUSION: Substantial increases in pregabalin prescribing were identified in Australian general practice, but only half of patients had a neuropathic pain diagnosis recorded, the only approved indication for subsidy. High rates of same-day prescribing with opioids and benzodiazepines may put patients at increased risk of harm.

Keywords: epidemiology; gabapentinoids; general practice; neuralgia; neuropathic pain; pregabalin.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Pregabalin prescriptions as a proportion of all prescriptions by subsidy status.
Legend: Excludes 6411 (1.6%) pregabalin prescriptions with missing prescription subsidy status. Prior to March 2013, pregabalin was only subsidised for veterans and their dependants. PBS = Pharmaceutical Benefits Scheme; RPBS = Repatriation Pharmaceutical Benefits Scheme.
Figure 2.
Figure 2.. Proportion of active patients prescribed pregabalin by age group and sex, March 2012–February 2018 (n = 114 123).
Figure 3.
Figure 3.. Prevalence of same-day prescribing of pregabalin and an opioid or benzodiazepine by recorded condition among patients prescribed pregabalin for whom capture of same-day prescribing was available, March 2012–February 2018 (n = 64 461).
Legend: Conditions not mutually exclusive as patients could have multiple conditions.
See this image and copyright information in PMC

References

    1. Federico CA, Wang T, Doussau A, et al. Assessment of pregabalin postapproval trials and the suggestion of efficacy for new indications: a systematic review. JAMA Intern Med. 2019;179(1):90–97. doi: 10.1001/jamainternmed.2018.5705. - DOI - PubMed
    1. Montastruc F, Loo SY, Renoux C. Trends in first gabapentin and pregabalin prescriptions in primary care in the United Kingdom, 1993–2017. JAMA. 2018;320(20):2149–2151. doi: 10.1001/jama.2018.12358. - DOI - PMC - PubMed
    1. Johansen ME. Gabapentinoid use in the United States 2002 through 2015. JAMA Intern Med. 2018;178(2):292–294. doi: 10.1001/jamainternmed.2017.7856. - DOI - PMC - PubMed
    1. Kwok H, Khuu W, Fernandes K, et al. Impact of unrestricted access to pregabalin on the use of opioids and other CNS-active medications: a cross-sectional time series analysis. Pain Med. 2017;18(6):1019–1026. doi: 10.1093/pm/pnw351. - DOI - PubMed
    1. Cairns R, Schaffer AL, Ryan N, et al. Rising pregabalin use and misuse in Australia: trends in utilization and intentional poisonings. Addiction. 2019;114(6):1026–1034. doi: 10.1111/add.14412. - DOI - PubMed

LinkOut - more resources