Key result
US ambulatory visits involving gabapentinoids nearly quadruple to ~35 per 1,000 visits between 2003 and 2016.
Why the study?
Increasing gabapentinoid use has raised concerns of misuse and abuse in the US, but little is known about patient and prescriber characteristics over time in general clinical practice.
Cross-Sectional (n=260,100,000)
Yes
Absolute Event Rate: 34.9% vs 9.1%
p-value: p=<0.0001
Increasing gabapentinoid visits, often with opioids or benzodiazepines and off-label, warrants clinical caution; leaves open appropriateness and outcome implications.
Increasing gabapentinoid use has raised concerns of misuse and abuse in the United States (US). Little is known about the characteristics of gabapentinoid use in general clinical practice over time. This cross-sectional study used data from the National Ambulatory Medical Care Survey. We examined the trends of patient and prescriber characteristics and the diagnoses associated with US ambulatory care visits involving gabapentinoids for adult visits from 2003 to 2016. Using multivariable logistic regression, we estimated the adjusted proportion of gabapentinoid-involved visits among all visits and tested for trend significance. Among the weighted estimate of 260.1 million gabapentinoid-involved visits (aged 18–64 years: 61.8%; female: 61.9%; white: 85.5%), the adjusted annual proportion of gabapentinoid-involved visits nearly quadrupled from 2003 to 2016 (9.1 to 34.9 per 1000 visits; Ptrend < 0.0001), driven mainly by gabapentin. Nearly half had concurrent use with opioids (32.9%) or benzodiazepines (15.3%). Primary care physicians (45.8%), neurologists (8.2%), surgeons (6.2%), and psychiatrists (4.8%) prescribed two-thirds of the gabapentinoids. Most (96.6%) of the gabapentinoid visits did not have an approved indication for gabapentinoids among the first three diagnoses. Among US ambulatory care visits from 2003 to 2016, gabapentinoid use increased substantially, commonly prescribed by primary care physicians.
No takes yet. Share an insight, caveat, or question.
Zhou et al. (2019) conducted a cross-sectional in Ambulatory care visits (n=260,100,000). Gabapentinoids vs. Time (2003 vs 2016) was evaluated on Adjusted annual proportion of gabapentinoid-involved visits per 1000 visits (p=<0.0001). The adjusted annual proportion of gabapentinoid-involved ambulatory care visits in the US nearly quadrupled from 9.1 per 1000 visits in 2003 to 34.9 per 1000 visits in 2016.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: