(322) Trends in gabapentinoid prescribing: a nationwide Danish drug utilization study

Background: Pregabalin and gabapentin, initially developed as anticonvulsants, are increasingly used for pain and other conditions. This has led to concerns about overuse as well as potential misuse and abuse.

Objectives: To guide rational prescribing practices, we provide detailed nationwide data on the use of gabapentinoids in Denmark.

Methods: Nationwide descriptive drug utilization study using the Danish healthcare registries to describe the use of gabapentinoids among Danish adults 2010-2022. We described overall use patterns, temporal trends, user characteristics, skewness of use, treatment duration and concomitant medication use.

Results: The overall prevalence of gabapentinoid use among adults increased almost four-fold from 4.9 per 1000 adults in 2010 to 18 in 2022, with the highest use among individuals aged 80+ years (53 per 1000 in 2022). Gabapentin and pregabalin were used equally. Over the study period, the median age of users increased (58 years in 2010 to 62 years in 2022) while a decline was observed in the concomitant use of other drug classes, in particular benzodiazepines or opioids. Most gabapentinoids were initiated by general practitioners (76% in 2022). Only 8% of patients were continuously treated for three years following initiation, while 20% were currently treated after three years (allowing treatment breaks). The use of gabapentinoids were somewhat skewed, with 1% of users accounting for 7.3% of use.

Conclusions: The use of gabapentinoids has increased dramatically in recent years, in particular among the elderly. Overall adherence to treatment was very low. Increased attention to the increasing use of gabapentinoids is warranted to ensure rational use of this drug class.