Objectives To analyse the prevalence and incidence of pregabalin and gabapentin (P/G) prescriptions, typical therapeutic uses of P/G with special attention to pain-related diagnoses and discontinuation rates.
Design Secondary data analysis.
Setting Primary and secondary care in Germany.
Participants Four million patients in the years 2009–2015 (anonymous health insurance data).
Primary and secondary outcome measures P/G prescribing rates, P/G prescribing rates associated with pain therapy, analysis of pain-related diagnoses leading to new P/G prescriptions and the discontinuation rate of P/G.
Results In 2015, 1.6% of insured persons received P/G prescriptions. Among the patients with pain first treated with P/G, as few as 25.7% were diagnosed with a typical neuropathic pain disorder. The remaining 74.3% had either not received a diagnosis of neuropathic pain or showed a neuropathic component that was pathophysiologically conceivable but did not support the prescription of P/G. High discontinuation rates were observed (85%). Among the patients who had discontinued the drug, 61.1% did not receive follow-up prescriptions within 2 years.
Conclusion The results show that P/G is widely prescribed in cases of chronic pain irrespective of neuropathic pain diagnoses. The high discontinuation rate indicates a lack of therapeutic benefits and/or the occurrence of adverse effects.
- pain management
- diabetic neuropathy
- primary care
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Contributors AV: planned the study, discussed the results and wrote the manuscript. TP, LH: analysed data and discussed the manuscript. KMK: gave support to study design and discussed the manuscript. JW, JH, NDB, AB: discussed the results and the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data used in the analyses are entrusted in the Institute for Applied Health Research Berlin. Please contact: firstname.lastname@example.org.
Author note The study protocol is available on request. Please contact: email@example.com.
Patient consent for publication Not required.
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