Evaluate the Effect of Implementing Prescription Order Alert to Promote the Appropriate Use of Mirogabalin Besilate Tablets

Mirogabalin besylate is an effective treatment for neuropathic pain; nevertheless, its safe use requires appropriate dose adjustment based on renal function and adherence to a gradual dose escalation schedule. At Oita University Hospital, a prescription order alert prompting renal function–based dosing and appropriate dose escalation was implemented in the electronic medical record system in January 2025. This study evaluated the impact of introducing this alert on physicians’ prescribing behavior for mirogabalin besylate. Patients prescribed mirogabalin besylate tablets (2.5, 5, or 10 mg) at our hospital between July 2024 and June 2025 were included. Renal function testing rates, appropriate use rates among patients with impaired renal function, and prescription switch rates from 10 to 20 mg were compared before and after alert implementation. After implementation, renal function testing rates among patients prescribed 2.5-mg tablets demonstrated an increasing trend, despite that the difference was not statistically significant. In contrast, appropriate use significantly improved in patients with creatinine clearance <60 mL/min, particularly among those aged ≥65 years. Moreover, the rate of appropriate dose escalation from 10 to 20 mg after an interval of at least 7 days increased significantly. These findings suggest that prescription order alerts at the time of mirogabalin besylate prescribing promote renal function assessment and adherence to recommended dose escalation schedules, thereby improving appropriate use. As a low-cost and widely applicable intervention using standard electronic medical record functions, such alerts may represent a practical strategy for enhancing medication safety in clinical practice.