title: Use of pregabalin in patients with painful neuropathic disorders under the care of general practitioners in the U.K.
abstract: OBJECTIVE
  To examine the use of pregabalin in patients with painful neuropathic disorders under the care of general practitioners (GPs) in the U.K.
  
  
  METHODS
  Using a large U.K. database of GP encounters, we identified all persons aged > or = 18 years with at least one GP encounter with a diagnosis of a painful neuropathic disorder (eg, postherpetic neuralgia, diabetic peripheral neuropathy) between January 1, 2004 and July 31, 2006. Among these patients, we then identified those who initiated therapy with pregabalin; the date of initial receipt of pregabalin was designated the "index date." We then examined use of pregabalin over the 6-month period following this date ("follow-up"), as well as changes in the use of other pain-related medications (eg, opioids, tricyclic antidepressants [TCAs], other antiepileptics [AEDs]) between the 6-month period preceding the index date ("pretreatment") and follow-up. Patients with less than 6 months of pretreatment and follow-up data were excluded, as were those without any encounters during pretreatment for a painful neuropathic disorder.
  
  
  RESULTS
  A total of 1,400 patients (1.4% of all identified patients with painful neuropathic disorders) initiated therapy with pregabalin and met all other entry criteria; mean age was 62 years, and 58% were women. During pretreatment, most (54%) patients received three or more different types of pain-related medications. During follow-up, patients averaged four prescriptions for pregabalin, totaling 93 therapy days. Compared with pretreatment, fewer patients received other pain-related medications during follow-up, including TCAs (37% during pretreatment vs. 27% during follow-up), opioids (64% vs. 55%), and AEDs other than pregabalin (36% vs. 16%) (all P < 0.01).
  
  
  CONCLUSIONS
  In the U.K., many patients prescribed pregabalin by their GPs may have been refractory to other pain-related medications. Use of these medications declined following initiation of pregabalin therapy.
authors.affiliation: Policy Analysis Inc. (PAI), Brookline, Massachusetts 02445, USA.
authors.forename: Ariel
authors.initials: A
authors.lastname: Berger
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.forename: Ellen
authors.initials: E
authors.lastname: Dukes
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy*; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069583:Pregabalin; D006113:United Kingdom; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid