Evidence map›Paper›PMID 37380198›Full record

ArticleRegional anesthesia and pain medicine2024

Cohort study of new off-label gabapentin prescribing in chronic opioid users.

Jessica I Billig, Mark C Bicket, Maryam Yazdanfar, Vidhya Gunaseelan, Erika D Sears, Chad M Brummett, Jennifer F Waljee

Open access · greenAbstract read
In one paragraph

Article in Regional anesthesia and pain medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jessica I BilligOrthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA jibillig@gmail.com.ORCID 0000-0002-7586-6306
Mark C BicketAnesthesiology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0001-9406-5953
Maryam YazdanfarDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Vidhya GunaseelanDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Erika D SearsDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Chad M BrummettAnesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Jennifer F WaljeeUniv Michigan, Ann Arbor, Michigan, USA.
University of Michigan · USMichigan United · USWashington University in St. Louis · US

Funding

University of Michigan Fibromyalgia CORTP50AR070600 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HARRIS, RICHARD E · 2016 to 2021
$7.4M
oPIOIDS: Prevention of Iatrogenic Opioid Dependence after SurgeryR01DA042859 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BRUMMETT, CHAD M, WALJEE, JENNIFER FILIP · 2017 to 2021
$3.6M
NIAMS NIH HHS P50 AR070600NIDA NIH HHS R01 DA042859
6 · The paper itself

Abstract

introductionGabapentin is commonly prescribed as an off-label adjunct to opioids because of its safer risk profile. Recent evidence has shown an increased risk of mortality when coprescribed with opioids. Therefore, we aimed to evaluate whether the addition of off-label gabapentin in patients with chronic opioid use is associated with a reduction in opioid dosage.

methodsWe performed a retrospective cohort study of patients with chronic opioid use with a new off-label gabapentin prescription (2010-2019). Our primary outcome of interest was a reduction in opioid dosage measured via oral morphine equivalents (OME) per day after the addition of a new off-label gabapentin prescription.

resultsIn our cohort of 172,607 patients, a new off-label gabapentin prescription was associated with a decrease in opioid dosage in 67,016 patients (38.8%) (median OME/day reduction:13.8), with no change in opioid dosage in 24,468 patients (14.2%), and an increase in opioid dosage in 81,123 patients (47.0%) (median OME/day increase: 14.3). A history of substance/alcohol use disorders was associated with a decrease in opioid dosage after the addition of a new off-label gabapentin (aOR 1.20, 95% CI 1.16 to 1.23). A history of pain disorders was associated with a decrease in opioid dosage after the initiation of a new gabapentin prescription including arthritis (aOR 1.12, 95% CI 1.09 to 1.15), back pain (aOR 1.10, 95% CI 1.07 to 1.12), and other pain conditions (aOR 1.08, 95% CI 1.06 to 1.10).

conclusionsIn this study of patients with chronic opioid use, an off-label gabapentin prescription did not reduce opioid dosage in the majority of patients. The coprescribing of these medications should be critically evaluated to ensure optimal patient safety.

Indexed as

AlcoholismOpioid-Related DisordersAnalgesics, OpioidCohort StudiesGabapentinHumansOff-Label UsePainRetrospective StudiesAnalgesics, OpioidGabapentinAnalgesics, OpioidOpioid-Related DisordersPain Management

Identifiers

PMID37380198
PMCPMC11350632
OpenAlexW4382404397

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.