Over recent years, there have been increasing safety concerns around the prescribing of gabapentinoid medications for chronic pain.
A dramatic increase in the number of deaths where gabapentin or pregabalin was mentioned on the death certificate in England and Wales were reported, from 272 deaths registered in 2018 to 552 deaths registered in 2022.
There are a plethora of safety concerns relating to the use of gabapentinoids, ranging from dependence, diversion and misuse, to dizziness, somnolence and potentially fatal respiratory depression.
After undergoing a merger with a small neighbouring practice in one of the most socio-economically deprived areas of the South Wales valleys (according to Welsh Index of Multiple Deprivation 2019: Results report), prescribing data indicated a significant need to improve patient safety by reviewing the inappropriate prescribing of gabapentinoid medications.
Outcome data was measured retrospectively over a 1-year period. A total of 150 patients (approximately 3.75% of practice population) were found to have either gabapentin or pregabalin on their repeat prescription. A total of 106 patients were reviewed, at least once, by either a GP or a pharmacist.
Of these, 31 patients successfully weaned off their gabapentinoid medication completely, with a further 25 patients currently on a reducing regime. The defined daily dosage (DDD) per 1000 patients has reduced by 23.4% (from 2906.7 Quarter 4/2023 vs 2227.3 Quarter 4/2024).
