Physician Education about Gabapentinoid Prescription for Pregabalin

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Montreal General Hospital, Montréal, Canada
Pregabalin+2 More
Physician Education about Gabapentinoid Prescription - Other
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether a brief educational intervention can increase the rate of gabapentinoid deprescription for patients who are hospitalized.

See full description

Eligible Conditions

  • Pregabalin
  • Gabapentin
  • Polypharmacy

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Physician Education about Gabapentinoid Prescription will improve 1 primary outcome and 6 secondary outcomes in patients with Pregabalin. Measurement will happen over the course of At study enrollment and 8-weeks post-hospital discharge.

8-weeks post-hospital discharge
Gabapentinoid Discontinuation or Dose Reduction With Intention to Stop
Gabapentinoid Dose Reduction Without Intention to Stop
Increase in Doses of Current Pain Medication
Initiation of New Pain Medication
At study enrollment and 8-weeks post-hospital discharge
Chronic Pain Intensity
Cognition
Health and Global Function

Trial Safety

Trial Design

2 Treatment Groups

Usual Medical Care
1 of 2
In-Hopsital Patient Educational Brochure and Physician Education about Gabapenti...
1 of 2
Active Control
Experimental Treatment

This trial requires 160 total participants across 2 different treatment groups

This trial involves 2 different treatments. Physician Education About Gabapentinoid Prescription is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

In-Hopsital Patient Educational Brochure and Physician Education about Gabapentinoid PrescriptionDuring the intervention period, patients admitted to the study sites who qualify for the trial will receive an in-hospital educational brochure. Additionally, the medical team will attend an educational session about gabapentinoid prescription.
Usual Medical CareDuring the control period, patients admitted to the study sites who qualify for the trial will receive a pharmacy medication reconciliation as part of usual medical care. Study participants will be informed that the goal of the trial is to evaluate medication use and medication changes after discharge, but they will not be informed that gabapentinoids are specifically being targeted. Medical staff will not receive specific information about the trial, or particular instructions with regards to deprescription during the control period.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 8-weeks post-hospital discharge
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 8-weeks post-hospital discharge for reporting.

Who is running the study

Principal Investigator
E. M.
Prof. Emily McDonald, MD
McGill University Health Centre/Research Institute of the McGill University Health Centre

Closest Location

Montreal General Hospital - Montréal, Canada

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There is one eligibility criterion to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
All inpatients 60 years or older admitted to study units who have a gabapentinoid prescription prior to admission

Patient Q&A Section

What is pregabalin?

"A wide number of clinical and veterinary practitioners in Australia have the opportunity to prescribe pregabalin, a licensed gabapentinoid. In the event of an adverse event, the use and appropriate referral of veterinary veterinary assistance is essential." - Anonymous Online Contributor

Unverified Answer

What causes pregabalin?

"In this article, we discuss the role of anion gap, a test commonly used pregabalin monitoring, which has previously been investigated. In the literature regarding anion gap, the major focus has been on assessing anion gap to predict the presence of methanol or ethylene glycol in a patient's blood. The current report is the first to describe a causal association between anion gap and the cause for pregabalin." - Anonymous Online Contributor

Unverified Answer

What are common treatments for pregabalin?

"Pregabalin has a number of popular treatment options including long-term daily dosages on an as needed or prn basis, and the use of short-acting prn dosages as an alternative to long-term daily use, and also as a short-term prn option for those who struggle with long-term daily use. Pregabalin is a very effective drug and effective treatment option for the management of fibromyalgia. As its use is expanding this will likely lead to a rise in prescribing, and the potential for a number of other side-effects." - Anonymous Online Contributor

Unverified Answer

Can pregabalin be cured?

"Pregabalin may improve [chronic pain](https://www.withpower.com/clinical-trials/chronic-pain) in a significant proportion of patients without causing any side effects. However, although the pain relief may be significant for many patients, the number and magnitude may be underestimated once remission is considered. Many patients and clinicians need further information about ongoing and future potential harm to the kidneys and blood pressure." - Anonymous Online Contributor

Unverified Answer

What are the signs of pregabalin?

"While the symptoms were fairly similar to those of the placebo group, the signs of PGP show a difference between the two groups. This difference occurs in the early period of treatment, which could be used as a sign that treatment is working in the patient's body. The difference might be attributable to the difference in dose used in the PGP group. Further research is required to clarify the effectiveness of PGP compared to placebo using the same dose and for a longer period." - Anonymous Online Contributor

Unverified Answer

How many people get pregabalin a year in the United States?

"around 20 million people in the United States take the medication prescribed for their pain. The majority (around 50%) of these patients have not had a proper assessment of the pain and are prescribed PGE1 or COX2-inhibiting analgesics. Such patients might feel better in a few days. However, there is no evidence that pregabalin has significant benefit on PGE1 and COX2 inhibitors, and the analgesicity of pregabalin may be only occasional, and not to be considered a main benefit." - Anonymous Online Contributor

Unverified Answer

What is the average age someone gets pregabalin?

"Pregabalin is used extensively in [Pain management clinics], and as a prescription drug, as a consequence for those not already receiving it. It is commonly prescribed and dispensed for a number of indications. However, as a prescription drug, pregabalin may be dispensed for a wider range of conditions than any one single indication. Therefore, a wider age range of people may receive it and for a number of people, the potential side effects of pregabalin may be less severe." - Anonymous Online Contributor

Unverified Answer

What is the primary cause of pregabalin?

"Data from a recent study of our meta-analysis show that the evidence to support the use of gabapentinoids to reduce neuropathic pain is stronger than any of these potential risk factors. This includes those that were evaluated in terms of the use of gabapentinoids to treat neuropathic pain. Therefore, gabapentinoids can be used for the treatment of chronic neuropathic pain like diabetic neuropathy and peripheral neuropathy. However, gabapentinoids can be used to treat neuropathic pain in multiple other situations, like postherpetic neuralgia (PHN), neuropathic pain due to cancer or stroke, and for treating fibromyalgia." - Anonymous Online Contributor

Unverified Answer

What does physician education about gabapentinoid prescription usually treat?

"The majority of the physicians did not think that the use of gabapentinoids in the management of neuropathic pain is useful and that such non use has little medical rationale. More specific information or even simple guidelines could potentially improve prescribing behavior." - Anonymous Online Contributor

Unverified Answer

Have there been other clinical trials involving physician education about gabapentinoid prescription?

"A small number of patients were referred to a specialty pharmacy because they wanted to avoid prescription drugs; of these patients, gabapentinoids were the drug of choice. Most of the patients continued their doctors' recommendation; a minority of them continued to use nonsteroidal anti-inflammatory drugs. Only seven patients enrolled in the study finished their year: six received gabapentinoid treatment plus nonsteroidal anti-inflammatory drug therapy, one received only nonsteroidal anti-inflammatory drug therapy, and none received placebo. The study failed to show benefit for gabapentinoid therapy (0.97, 95% CI, 0.83 to 1.09), nonsteroidal anti-inflammatory drug therapy (0.83, 0." - Anonymous Online Contributor

Unverified Answer

Is physician education about gabapentinoid prescription typically used in combination with any other treatments?

"Many physicians use gabapentinoids as part of treatment for DPN, but only one third reported having been informed about these drugs by their prescribing physician. In our study, the willingness and knowledge of physicians to inform patients about gabapentinoid treatment was related to the years' experience, and to a higher degree by neurology versus gastroenterology." - Anonymous Online Contributor

Unverified Answer

Is physician education about gabapentinoid prescription safe for people?

"A clear and consistent understanding of prescribing for people receiving gabapentinoid is important for safety. Patient education and education about gabapentinoids is critical to patient safety." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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