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Purpose <p>With pain treatment shifting away from opioids, alternative analgesics—such as gabapentinoids—are increasingly being used. This study investigated the prevalence and indications for gabapentinoid use among geriatric outpatients, a population particularly vulnerable to central nervous system (CNS)-active drugs.</p> Methods <p>A retrospective cross-sectional chart review was conducted among patients visiting the geriatric falls clinic at Aalborg University Hospital, Denmark, in 2013–14, 2018–19 and 2023. Demographic data, comorbidities, medication status, fall frequency, in-clinic measurements, reported pain and dizziness, frailty status, as well as indications for gabapentinoid prescriptions were extracted and classified according to guidelines.</p> Results <p>A total of 773 patients were screened, and 635 included (2013/2018/2023, <i>n</i> = 144/265/226). The mean age was 81.2 years, 59% were female, and nearly half of the patients were frail (Clinical Frailty Scale (CFS) ≥ 5). Chronic pain was increasingly reported at the falls clinic (46/62/68%, <i>p</i> &lt; 0.001). Gabapentinoid use increased with time (3.5/10.9/15%, <i>p</i> = 0.002), while opioid use decreased (29.2/19.2/11.9%, <i>p</i> &lt; 0.001). A total of 65 patients took gabapentinoids for pain, of which 42 (62%) were not supported by guidelines; 18 (26%) were vaguely supported, while only five (7%) were clearly supported by guidelines. Most had been on gabapentinoids for &gt; 1 year, and deprescription was initiated in approximately 40%.</p> Conclusions <p>A marked increase in gabapentinoid use among patients assessed at the geriatric falls clinic was found, with a corresponding decrease in opioid use. The majority of gabapentinoid prescriptions were for indications not supported by guidelines.</p>

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Trends and Guideline Adherence in Gabapentinoid Use among Geriatric Outpatients: A Retrospective Cross-Sectional Study at a Falls Clinic

  • 期刊论文

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  • 发表日期：

    2025年10月21日

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  • Hussein Alkafaji,
  • Jesper Schmidt,
  • Johannes Riis,
  • Dmitri Zintchouk,
  • Stig Andersen

摘要

Purpose

With pain treatment shifting away from opioids, alternative analgesics—such as gabapentinoids—are increasingly being used. This study investigated the prevalence and indications for gabapentinoid use among geriatric outpatients, a population particularly vulnerable to central nervous system (CNS)-active drugs.

Methods

A retrospective cross-sectional chart review was conducted among patients visiting the geriatric falls clinic at Aalborg University Hospital, Denmark, in 2013–14, 2018–19 and 2023. Demographic data, comorbidities, medication status, fall frequency, in-clinic measurements, reported pain and dizziness, frailty status, as well as indications for gabapentinoid prescriptions were extracted and classified according to guidelines.

Results

A total of 773 patients were screened, and 635 included (2013/2018/2023, n = 144/265/226). The mean age was 81.2 years, 59% were female, and nearly half of the patients were frail (Clinical Frailty Scale (CFS) ≥ 5). Chronic pain was increasingly reported at the falls clinic (46/62/68%, p < 0.001). Gabapentinoid use increased with time (3.5/10.9/15%, p = 0.002), while opioid use decreased (29.2/19.2/11.9%, p < 0.001). A total of 65 patients took gabapentinoids for pain, of which 42 (62%) were not supported by guidelines; 18 (26%) were vaguely supported, while only five (7%) were clearly supported by guidelines. Most had been on gabapentinoids for > 1 year, and deprescription was initiated in approximately 40%.

Conclusions

A marked increase in gabapentinoid use among patients assessed at the geriatric falls clinic was found, with a corresponding decrease in opioid use. The majority of gabapentinoid prescriptions were for indications not supported by guidelines.