Adults in the United States with cancer more than doubled their use of gabapentinoid medication from 2005 to 2015 for long-term pain control, according to data published in Supportive Care in Cancer. Researchers said this trend is problematic considering that the drugs’ mechanisms of action are unclear, and patients may develop a physical dependence on them.
Alex Fauer, BSN, RN, OCN, a PhD candidate at the University of Michigan School of Nursing, told Healio Primary Care that during a 2-year period during his clinical work as a bone marrow transplant nurse, he noticed that an increasing number of patients were being prescribed gabapentin for complex cancer pain syndromes, such as chemotherapy-induced neuropathic pain.
“I thought that this phenomenon wasn’t occurring only at my practice, so I conducted a secondary analysis of Medical Expenditure Panel Survey data during my doctoral studies,” he said.
In their research, Fauer and colleagues found that the adjusted percentage of gabapentinoid users among patients with cancer rose across the United States from 2.3% in 2005 to 5.6% in 2015 (P < .001). In 2005, the number of gabapentinoid prescriptions in this cohort was approximately 1.19 million, and by 2015, it grew to approximately 3.52 million (P < .01).
Fauer and colleagues suspect that more recent data would show that the trend would continue beyond 2015.
“Potential drivers for this trend may be the increase in the number of adult cancer survivors with need for chronic pain therapy and the peak of the opioid crisis,” he said. “Though we can’t yet quantify how beneficial gabapentinoids are for cancer pain syndromes, prescribers should provide as much education as possible, with follow-up, to patients and caregivers on the risks and self-monitoring concerns of gabapentinoids.”
Fauer added that future research should focus on understanding gabapentinoids’ mechanisms of action in cancer pain syndromes, so that there is “high-quality evidence” to support their use for cancer pain syndromes.
“Additionally, we could use data sources with high-quality information regarding drug dosage and patient pain to investigate gabapentinoid efficacy, and control for confounding factors,” he said. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.