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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

Nielsen, S, Gisev, N, Leung, J, Clare, P, Bruno, R ORCID: 0000-0001-6673-833X, Lintzeris, N, Larance, B, Blyth, F, Hall, W, Cohen, M, Degenhardt, L, Farrell, M and Campbell, G 2020 , '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 , doi: 10.1111/bcp.14715.

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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 andclinical outcomes of pregabalin use among an Australian community-based cohort ofpeople prescribed opioids for chronic non-cancer pain.Methods: Through a five-year prospective cohort study (n = 1514) we examinedassociations between pregabalin use and pain severity and interference, mentalhealth, opioid dose and past month use of ambulance and emergency departmentservices. 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), theprevalence of pregabalin use ranged from 16% at cohort entry to 29% at 36- and48-months, and 46% reported pregabalin use at any time during the five years.Pregabalin use was associated with greater pain severity and interference and greateruse of high-risk opioid doses (>90 oral morphine equivalents/day). Pregabalin use was not associated with changes in mental health symptoms, ambulance oremergency department attendance in the fixed or random effects models.Conclusions: Pregabalin use was common, but for most people use was notassociated with clinically meaningful improvements in pain or functioning.

Item Type: Article
Authors/Creators: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
Keywords: cohort, gabapentinoids, opioid, pain, pharmacoepidemiology, pregabalin
Journal or Publication Title: British Journal of Clinical Pharmacology
Publisher: Blackwell Publishing Ltd
ISSN: 0306-5251
DOI / ID Number: 10.1111/bcp.14715
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