Misuse of Gabapentinoid Low in Texas Medicaid Recipients

Misuse of gabapentinoid, often considered a safer alternative to opioids, was low among a group of Texas Medicaid recipients, according to a poster presented at AMCP 2021.

Higher levels of misuse were significantly associated with younger age, male gender, neuropathic pain diagnosis (odds ratio [OR]=2.065), and pregabalin use (OR=2.337), reported Elizabeth A. Ibiloye, Health Outcomes Division, University of Texas at Austin, and colleagues.

The retrospective study looked at 39,000 patients aged 18 to 63 with at least one gabapentinoid prescription from the Texas Medicaid prescription and medical claims from January 2012 to August 2016. Patients had continuous enrollment for six months pre-index and 12 months post-index. The researchers looked for three or more claims within a 12-month post-index period that exceeded the FDA approved daily dose threshold of 3,600 mg for gabapentin and 600 mg for pregabalin.

Only 0.2% of the patients met the pre-defined criteria for gabapentinoid misuse. Of these, 60% were using gabapentin and 40% were using pregabalin. More than three-quarters (76.4%) of misuse was among those aged 41 to 63; misuse decreased with age. About half of patients had a diagnosis of neuropathic pain, and misuse was higher in these patients (0.3%). Although more patients were using gabapentin (77.4%) than pregabalin, misuse was higher among pregabalin (0.2% vs. 0.4%; P=0.0003). Finally, about 17% of patients using gabapentinoid had at least 90 days of concurrent opioid use, but there was no difference in gabapentinoid misuse between concurrent and non-concurrent opioid users.

The researchers noted that it is possible that gabapentinoid misuse may not be prevalent in the population examined in this study or that not all misuse was captured.

Ibiloye EA, et al. Prevalence of and factors associated with gabapentinoid use and misuse among Texas Medicaid recipients. Poster G44. Presented at AMCP 2021; April 12-16, 2021.