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Retrospective Cohort Study of the Prevalence of Off‐label Gabapentinoid Prescriptions in Hospitalized Medical Patients
Author(s) -
Gingras MarcAlexandre,
Lieu Anthony,
PapillonFerland Louise,
Lee Todd C,
McDonald Emily G
Publication year - 2019
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.3203
Subject(s) - medicine , deprescribing , pregabalin , medical prescription , retrospective cohort study , gabapentin , cohort , dosing , emergency medicine , off label use , pediatrics , polypharmacy , alternative medicine , psychiatry , pharmacology , pathology
Gabapentinoid prescriptions are increasing in North America, with frequent off‐label use despite limited proven efficacy. This retrospective cohort study describes prescribing trends among hospitalized patients with a focus on dosing and deprescribing. We examined consecutive inpatients between December 2013 and July 2017 on a 52‐bed medical unit in Montréal, Canada. Prevalence of off‐label use, median doses prescribed, and deprescribing trends were analyzed over time. Of 4,103 hospitalized patients, 550 (13.4%) were prescribed gabapentinoids preadmission, with two patients being coprescribed gabapentin and pregabalin (total 552 prescriptions). A minority (94/552, or 17%) were for approved indications. Although it was uncommon for gabapentinoids to be newly prescribed in hospital, preadmission gabapentinoids were also seldom deprescribed (65/495 patients discharged alive, or 13%). Given a high prevalence of use, limited efficacy, and potential harms, gabapentinoids may represent an ideal target for re‐evaluation of indication and effectiveness in hospitalized adults, with consideration given to deprescribing.