How the Reclassification of Gabapentinoids Reshaped Neuropathic Pain Treatment in Saudi Arabia: A Survey of Healthcare Professionals
摘要
This study aimed to assess knowledge gaps, perceptions, and prescribing approaches of healthcare professionals (HCPs) in Saudi Arabia regarding pain management, particularly neuropathic pain, in the context of recent reclassification of gabapentinoids.
MethodsA three-lecture webinar was attended by 4922 HCPs across Saudi Arabia. Two structured surveys were embedded within the lectures: a 9-item knowledge questionnaire on pain management and a 10-item questionnaire on HCPs’ opinions and attitudes on gabapentinoid use and prescribing challenges. Responses were recorded on the platform’s interactive dashboard as percentage. The knowledge scores were normalized to percentage.
ResultsOverall knowledge levels varied across specialties with internal medicine (68.7%) and pain specialists (68.3%) having the top scores; non-pain organ specialists scored the lowest (59.1%). The majority of HCPs (68.8%) agreed that prescribing gabapentinoids has become more challenging than prescribing tramadol post reclassification, with patients’ concerns related to substance dependence (32.6%) and extended process in obtaining medication (27.9%) cited by the majority. Gabapentinoids remained the preferred treatment for diabetic peripheral neuropathy by most HCPs (36.8%). Most HCPs (47.4%) reported initiating gabapentinoids at the lowest possible dose and increasing as needed, while a smaller proportion preferred initiating an appropriate dose with minimal adjustments (18.5%). Among pain specialists, these approaches were nearly evenly divided (37.7% and 31.9%, respectively). The majority (45.7%) selected pregabalin 300 mg as their preferred daily dose for transitioning from gabapentin 900 mg.
ConclusionsThis nationwide survey highlights substantial variability and knowledge gaps related to general pain, neuropathic pain management, and excessive caution among HCPs regarding prescribing gabapentinoids and patient concerns of developing dependence. To maintain gabapentinoid access and timely care for patients with legitimate needs, there is a need to implement educational programs for HCPs across specialties and develop a unified treatment approach that fulfils the guidelines and addresses exaggerated patient worries along with patient-focused initiatives to reduce hesitancy post reclassification of gabapentinoids.