• Annika Viniol, Tina Ploner, Lennart Hickstein, Jörg Haasenritter, Karl Martin Klein, Jochen Walker, Norbert Donner-Banzhoff, and Annette Becker.
• Department of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Marburg, Germany.
• BMJ Open. 2019 Mar 30; 9 (3): e021535.

ObjectivesTo analyse the prevalence and incidence of pregabalin and gabapentin (P/G) prescriptions, typical therapeutic uses of P/G with special attention to pain-related diagnoses and discontinuation rates.DesignSecondary data analysis.SettingPrimary and secondary care in Germany.ParticipantsFour million patients in the years 2009-2015 (anonymous health insurance data).InterventionNone.Primary And Secondary Outcome MeasuresP/G prescribing rates, P/G prescribing rates associated with pain therapy, analysis of pain-related diagnoses leading to new P/G prescriptions and the discontinuation rate of P/G.ResultsIn 2015, 1.6% of insured persons received P/G prescriptions. Among the patients with pain first treated with P/G, as few as 25.7% were diagnosed with a typical neuropathic pain disorder. The remaining 74.3% had either not received a diagnosis of neuropathic pain or showed a neuropathic component that was pathophysiologically conceivable but did not support the prescription of P/G. High discontinuation rates were observed (85%). Among the patients who had discontinued the drug, 61.1% did not receive follow-up prescriptions within 2 years.ConclusionThe results show that P/G is widely prescribed in cases of chronic pain irrespective of neuropathic pain diagnoses. The high discontinuation rate indicates a lack of therapeutic benefits and/or the occurrence of adverse effects.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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