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Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non-cancer pain: a five-year prospective cohort study

Citation

Nielsen, S and Gisev, N and Leung, J and Clare, P and Bruno, R and Lintzeris, N and Larance, B and Blyth, F and Hall, W and Cohen, M and Degenhardt, L and Farrell, M and Campbell, G, Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non-cancer pain: a five-year prospective cohort study, British Journal of Clinical Pharmacology pp. 1-13. ISSN 0306-5251 (2020) [Refereed Article]

DOI: doi:10.1111/bcp.14715

Abstract

Aims: Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic non-cancer pain, but few studies have examined its clinical efficacy outside trials. We address this gap by examining the utilization, correlates and clinical outcomes of pregabalin use among an Australian community-based cohort of people prescribed opioids for chronic non-cancer pain.

Methods: Through a five-year prospective cohort study (n = 1514) we examined associations between pregabalin use and pain severity and interference, mental health, opioid dose and past month use of ambulance and emergency department services. We used fixed-effects regression models to examine within-participant differences, and random-effects regression models to examine within- and between participant differences in clinical outcomes.

Results: In an analysis of cases with complete data over five-years (n = 896), the prevalence of pregabalin use ranged from 16% at cohort entry to 29% at 36- and 48-months, and 46% reported pregabalin use at any time during the five years. Pregabalin use was associated with greater pain severity and interference and greater use of high-risk opioid doses (>90 oral morphine equivalents/day). Pregabalin use was not associated with changes in mental health symptoms, ambulance or emergency department attendance in the fixed or random effects models.

Conclusions: Pregabalin use was common, but for most people use was not associated with clinically meaningful improvements in pain or functioning.

Item Details

Item Type:Refereed Article
Keywords:cohort, gabapentinoids, opioid, pain, pharmacoepidemiology, pregabalin
Research Division:Psychology
Research Group:Clinical and health psychology
Research Field:Health psychology
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Substance abuse
UTAS Author:Bruno, R (Associate Professor Raimondo Bruno)
ID Code:142754
Year Published:2020
Web of Science® Times Cited:2
Deposited By:Psychology
Deposited On:2021-02-10
Last Modified:2021-03-16
Downloads:0

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