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

Suzanne Nielsen, Natasa Gisev, Janni Leung, Philip Clare, Raimondo Bruno, Nicholas Lintzeris, Briony Larance, Fiona Blyth, Wayne Hall, Milton Cohen, Louisa Degenhardt, Michael Farrell, Gabrielle Campbell

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)3092-3104
Number of pages13
JournalBritish Journal of Clinical Pharmacology
Volume87
Issue number8
DOIs
Publication statusPublished - Aug 2021

Keywords

  • cohort
  • gabapentinoids
  • opioid
  • pain
  • pharmacoepidemiology
  • pregabalin

Cite this