Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin
Objectives The objectives of this study were to investigate the utilisation patterns of pregabalin, to identify users potentially misusing pregabalin and to compare this group of patients to patients prescribed recommended doses of pregabalin concerning their personal characteristics and the coordin...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060104.full |
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| author | Ronja Flemming |
| author_facet | Ronja Flemming |
| author_sort | Ronja Flemming |
| collection | DOAJ |
| description | Objectives The objectives of this study were to investigate the utilisation patterns of pregabalin, to identify users potentially misusing pregabalin and to compare this group of patients to patients prescribed recommended doses of pregabalin concerning their personal characteristics and the coordination among their prescribers. Unintended coprescription of drugs with addictive potential might occur when care is insufficiently coordinated.Design Secondary data analysis of linked data from three regional sickness funds in Germany (AOK) for the years 2014–2016.Setting Ambulatory and hospital care sector in four German federal states.Methods On the basis of routine data, patients who received at least three prescriptions of pregabalin were identified and classified into patients prescribed pregabalin as recommended and those dispensed with a higher than recommended dose (>600 mg/day). Social network analysis was applied to identify prescription networks and to analyse cooperation among the prescribers. With descriptive statistics and univariate statistical tests, typical characteristics of the group of patients potentially misusing pregabalin were compared with the others.Results Among the 53 049 patients prescribed pregabalin, about 2% (877) were classified as potentially misusing pregabalin. The majority of this group was male and aged between 30 and 60 years. Of the patients misusing pregabalin, 365 (42%) had a diagnosed history of substance use disorders and 359 (41%) had been prescribed another drug with addictive potential (opioids) before. The prescribers of those patients potentially misusing pregabalin were more loosely connected within networks compared with prescribers of patients prescribed pregabalin as recommended.Conclusion This study found that patients could exceed recommended doses of pregabalin by getting prescriptions from multiple physicians. Specific patients were at increased risk of potentially misusing pregabalin, and these patients sought to obtain their prescriptions from physicians who were as loosely connected as possible. Coordination and sharing a relevant number of patients seem to be levers to avoid these problems of unintended coprescribing. |
| format | Article |
| id | doaj-art-df8c1e5e3d684ed995625e25ba978cf9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-df8c1e5e3d684ed995625e25ba978cf92025-01-30T19:15:11ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060104Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalinRonja Flemming0Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, GermanyObjectives The objectives of this study were to investigate the utilisation patterns of pregabalin, to identify users potentially misusing pregabalin and to compare this group of patients to patients prescribed recommended doses of pregabalin concerning their personal characteristics and the coordination among their prescribers. Unintended coprescription of drugs with addictive potential might occur when care is insufficiently coordinated.Design Secondary data analysis of linked data from three regional sickness funds in Germany (AOK) for the years 2014–2016.Setting Ambulatory and hospital care sector in four German federal states.Methods On the basis of routine data, patients who received at least three prescriptions of pregabalin were identified and classified into patients prescribed pregabalin as recommended and those dispensed with a higher than recommended dose (>600 mg/day). Social network analysis was applied to identify prescription networks and to analyse cooperation among the prescribers. With descriptive statistics and univariate statistical tests, typical characteristics of the group of patients potentially misusing pregabalin were compared with the others.Results Among the 53 049 patients prescribed pregabalin, about 2% (877) were classified as potentially misusing pregabalin. The majority of this group was male and aged between 30 and 60 years. Of the patients misusing pregabalin, 365 (42%) had a diagnosed history of substance use disorders and 359 (41%) had been prescribed another drug with addictive potential (opioids) before. The prescribers of those patients potentially misusing pregabalin were more loosely connected within networks compared with prescribers of patients prescribed pregabalin as recommended.Conclusion This study found that patients could exceed recommended doses of pregabalin by getting prescriptions from multiple physicians. Specific patients were at increased risk of potentially misusing pregabalin, and these patients sought to obtain their prescriptions from physicians who were as loosely connected as possible. Coordination and sharing a relevant number of patients seem to be levers to avoid these problems of unintended coprescribing.https://bmjopen.bmj.com/content/12/7/e060104.full |
| spellingShingle | Ronja Flemming Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin BMJ Open |
| title | Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin |
| title_full | Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin |
| title_fullStr | Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin |
| title_full_unstemmed | Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin |
| title_short | Patterns of pregabalin prescribing in four German federal states: analysis of routine data to investigate potential misuse of pregabalin |
| title_sort | patterns of pregabalin prescribing in four german federal states analysis of routine data to investigate potential misuse of pregabalin |
| url | https://bmjopen.bmj.com/content/12/7/e060104.full |
| work_keys_str_mv | AT ronjaflemming patternsofpregabalinprescribinginfourgermanfederalstatesanalysisofroutinedatatoinvestigatepotentialmisuseofpregabalin |