Gabapentinoid prescriptions for neuropathic and musculoskeletal pain in Lebanon

Abstract

Aim: The purpose of this study is to analyze the different characteristics of gabapentinoids prescription by Lebanese orthopedics surgeons. Methods: This is an observational, cross-sectional study using a survey which was carried out in collaboration with the Lebanese Orthopedic Society over a 3-month period. Results: Forty-two orthopedic surgeons responded, most of them prescribing gabapentinoids in their daily practice with only half of the patients feeling relief after taking them. Furthermore, most of the surgeons prescribed these drugs for patients above 18 years old and for both acute and chronic pain. Conclusion: Even though almost half of the patients do not experience relief after taking gabapentinoids, these drugs are becoming more and more prescribed.

Plain language summary

With pain being a major concern in orthopedic surgery, a lot of surgeons prescribe drugs before surgical procedures for their patients. One of these drugs categories include Gabapentinoids. This class of medications was shown to be prescribed more and more by orthopedic surgeons despite it not granting successful pain relief for half of the patients and not being US FDA approved.

Summary points

• 97.62% of surveyed orthopedic physicians prescribe gabapentinoids in daily practice with neuropathic and musculoskeletal pain being the main indication.

• 83% of surveyed surgeons use gabapentinoids when initial treatment for orthopedic pain fails with pregabalin (PGB) being prescribed slightly more (51.2%) than gabapentin (GBP) (48.8%).

• Minimum effective dose: 300 mg for GBP (70.73%), 75 mg for PGB (66.67%) with common side effects: dizziness (80.95%), somnolence (76.19%), visual disturbances (30.95%) being unrelated to the dosage.

• 97.62% prescribe gabapentinoids with other analgesics, and rarely as monotherapy (2.38%).

• Criteria influencing choice: type of pain (67.5%), safety and side-effect profile (57.5%) with age not considered a limiting factor by 63.41% of surveyed surgeons.

• Despite nearly half of the individuals not finding relief with gabapentinoids, the prescription of these medications is on the rise.

Author contributions

J Rassi, S Khazaka, S Hlais: writing draft. S Rassi: data collection and writing draft. M Daher: data collection and editing draft. T Samaha: supervision and editing draft.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The study was approved by the Ethics Committees of the Saint Joseph university. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.