ORIJINAL ARAŞTIRMA
Fiziksel Tıp ve Rehabilitasyon Kliniğinde Yatan Hastalarda Gabapentinoid İlaç Kullanım Yaygınlığının Retrospektif Kohort Çalışması
Retrospective Cohort Study of Gabapentinoid Drug Use in Hospitalized Physical Medicine and Rehabilitation Clinic Patients
Received Date : 21 Mar 2021
Accepted Date : 07 May 2021
Available Online : 24 May 2021
Sevinç KÜLEKÇİOĞLUa, Merve AKYÜZa, Alp ÇETİNb
aClinic of Physical Medicine and Rehabilitation, Bursa City Hospital, Bursa, TURKEY
bDepartment of Physical Medicine and Rehabilitation, Ankara Hacettepe University Faculty of Medicine, Ankara, TURKEY
Doi: 10.31609/jpmrs.2021-83224 - Makale Dili: EN
J PMR Sci. 2022;25(1):20-6
ÖZET
Amaç: Bu çalışmanın amacı, yatarak tedavi gören kas iskelet
sistemi bozukluğu olan hastalarda, gabapentinoid kullanım oranlarını
araştırmak ve bu ilaçların hangi durumlarda, hangi dozlarda ve süreyle
kullanıldığını gözden geçirmektir. Gereç ve Yöntemler: Temmuz 2019
ile Temmuz 2020 tarihleri arasında Bursa Şehir Hastanesi Fizik Tedavi
ve Rehabilitasyon kliniğinde yatan 18 yaş üstü tüm hastalar, cinsiyet
farkına bakılmaksızın çalışmaya dâhil edildi. Hastaların demografik
özellikleri, sigara alışkanlıkları, tanıları, kullanılan gabapentinoid ilacın
adı, kullanım süre ve dozu, gabapentinoid ile birlikte kullanılan diğer
ilaçlar ve hastalıklar kaydedildi. Bulgular: 620 hastanın, 173’ünde
(%27,9), gabapentinoid kullanımı tespit edildi. 173 hastanın 88’inin gabapentin,
85’inin pregabalin kullandığı belirlendi. Ağırlıklı olarak nöropatik
ağrı endikasyonu ile kullanılan gabapentinoidlerin tavsiye
edilenden daha düşük dozda kullanıldığı belirlendi. Sonuç: Yatarak tedavi
gören Fizik Tedavi ve Rehabilitasyon hastaları grubumuzda, gabapentinoid
kullanımı oldukça yaygındır. Gabapentinoidlerin genel
olarak tavsiye edilenden düşük dozlarda kullanılmasının nedenlerini araştıran
ileri çalışmalara ihtiyaç duyulmaktadır. Her ne kadar bağımlılıkla ilgili
endişelere yol açsa da ağrı kontrolünde sıkça tercih edilmeleri
gabapentinoidlerin doğru endikasyon ve dozlarda kullanıldığında oldukça
yararlı olduğunu düşündürmektedir.
Anahtar Kelimeler: Gabapentinoid; gabapentin; pregabalin; ağrı; nöropatik ağrı
ABSTRACT
Objectives: The aim of this study is to investigate the
gabapentinoid utilization rates in musculoskeletal system inpatients and
to review the conditions, doses and durations of utilization. Material
and Methods: All inpatients over 18 receiving treatment in physical
medicine and rehabilitation clinic of Bursa City Hospital between July
2019 and July 2020 were included in this retrospective study regardless
of gender differences. The demographic characteristics of patients,
smoking habits, diagnoses, the name of the gabapentinoid drug utilized,
the dose used, the duration of utilization, and other drugs utilized concomitantly
with gabapentinoid and any additional diseases were
recorded. Results: Gabapentinoid use was detected in 173 (27.9%) of
620 patients. It was determined that 88 of 173 patients used gabapentin
and 85 were using pregabalin. It was determined that gabapentinoids
used mainly for neuropathic pain indication were used at lower doses
than recommended. Conclusion: Gabapentinoid use is quite common
in our group of inpatients with Physical Medicine and Rehabilitation.
More studies are needed to investigate the reasons for using gabapentinoids
at lower doses than generally recommended. Although they cause
concerns about addiction, their frequent use for pain control shows that
gabapentinoids are very beneficial when used in the correct indications
and doses.
Keywords: Gabapentinoid; gabapentin; pregabalin; pain; neuropathic pain
REFERENCES
- Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact chronic pain among adults - united states, 2016. MMWR Morb Mortal Wkly Rep. 2018;67:1001-6. [Crossref] [PubMed] [PMC]
- Altan L, Aksoy M. Kronik ağrı tanımı ve epidemiyolojisi [Definition of chronic pain and epidemiology]. Turkey Clinics J PM&R-Special Topics. 2017;10:229-33. [Link]
- Goodman CW, Brett AS. A clinical overview of off-label use of gabapentinoid drugs. JAMA Intern Med. 2019;179:695-701. [Crossref] [PubMed]
- Gingras MA, Lieu A, Papillon-Ferland L, et al. Retrospective cohort study of the prevalence of off-label gabapentinoid prescriptions in hospitalized medical patients. J Hosp Med. 2019;14:E1-E4. [Crossref] [PubMed] [PMC]
- Goodman CW, Brett AS. Gabapentinoids for Pain: Potential Unintended Consequences. Am Fam Physician. 2019;100:672-5. [PubMed]
- Zhou L, Bhattacharjee S, Kwoh CK, et al. Trends, patient and prescriber characteristics in gabapentinoid use in a sample of united states ambulatory care visits from 2003 to 2016. J Clin Med. 2019;9:83. [Crossref] [PubMed] [PMC]
- Schifano F. Misuse and abuse of pregabalin and gabapentin: cause for concern? CNS Drugs. 2014;28:491-6. [Crossref] [PubMed]
- Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016;65:1-49. Erratum in: MMWR Recomm Rep. 2016;65:295. [Crossref] [PubMed]
- Rosenquist EWK. Overview of the treatment of chronic non-cancer pain. Last updated February 5, 2019. Accessed February 11, 2019. [Link]
- Moulin D, Boulanger A, Clark AJ, et al; Canadian Pain Society. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014;19:328-35. [Crossref] [PubMed] [PMC]
- Szok D, Tajti J, Nyári A, et al. Therapeutic approaches for peripheral and central neuropathic pain. Behav Neurol. 2019;2019:86 85954. [Crossref] [PubMed] [PMC]
- Andrasinova T, Kalikova E, Kopacik R, et al. Evaluation of the neuropathic component of chronic low back pain. Clin J Pain. 2019;35:7-17. [Crossref] [PubMed]
- Robertson K, Marshman LAG, Plummer D, et al. Effect of gabapentin vs pregabalin on pain intensity in adults with chronic sciatica: A randomized clinical trial. JAMA Neurol. 2019; 76:28-34. Erratum in: JAMA Neurol. 2019;76: 117. [Crossref] [PubMed] [PMC]
- Tajti J, Szok D, Majláth Z, et al. Alleviation of pain in painful diabetic neuropathy. Expert Opin Drug Metab Toxicol. 2016;12:753-64. [Crossref] [PubMed]
- Harrison RA, Field TS. Post stroke pain: identification, assessment, and therapy. Cerebrovasc Dis. 2015;39:190-201. [Crossref] [PubMed]
- Arnold LM, Goldenberg DL, Stanford SB, et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum. 2007;56:13 36-44. [Crossref] [PubMed]
- Thakur M, Dickenson AH, Baron R. Osteoarthritis pain: nociceptive or neuropathic? Nat Rev Rheumatol. 2014;10:374-80. [Crossref] [PubMed]
- Appleyard T, Ashworth J, Bedson J, et al. Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care. Oste oarthritis Cartilage. 2019;27:1437-44. [Crossref] [PubMed]
- Cummins CA, Sasso LM, Nicholson D. Impingement syndrome: temporal outcomes of nonoperative treatment. J Shoulder Elbow Surg. 2009;18:172-7. [Crossref] [PubMed]
- Wanner V, Garcia Malo C, Romero S, et al. Non-dopaminergic vs. dopaminergic treatment options in restless legs syndrome. Adv Pharmacol. 2019;84:187-205. [Crossref] [PubMed]
- Wijemanne S, Ondo W. Restless Legs Syndrome: clinical features, diagnosis and a practical approach to management. Pract Neurol. 2017;17:444-52. [Crossref] [PubMed]
- Scholz J, Finnerup NB, Attal N, et al; Classification Committee of the Neuropathic Pain Special Interest Group (NeuPSIG). The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019;160:53-9. [Crossref] [PubMed] [PMC]
- Alviar MJ, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev. 2016;10:CD 006380. [PubMed] [PMC]
- Edinoff A, Sathivadivel N, McBride T, et al. Chronic pain treatment strategies in Parkinson's disease. Neurol Int. 2020;12:61-76. [Crossref] [PubMed] [PMC]
- Willen C, Hou L, Stibrant Sunnerhagen K. A very long-term longitudinal follow-up of persons with late effects of polio. Eur J Phys Rehabil Med. 2020;56:155-9. [Crossref] [PubMed]