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Research

Prescribing trends of gabapentin, pregabalin, and oxycodone: a secondary analysis of primary care prescribing patterns in England

Katlyn Green, Nora Cooke O'Dowd, Hilary Watt, Azeem Majeed and Richard J Pinder
BJGP Open 2019; 3 (3): bjgpopen19X101662. DOI: https://doi.org/10.3399/bjgpopen19X101662
Katlyn Green
1 Analyst, Public Private Ltd, London, UK
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  • For correspondence: katlynmgreen91@gmail.com
Nora Cooke O'Dowd
2 Public Health Intelligence Analyst, Public Health Division, Southwark Council, London, UK
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Hilary Watt
3 Consultant Statistician, Department of Primary Care and Public Health, Imperial College London, London, UK
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Azeem Majeed
4 Professor of Primary Care, Department of Primary Care and Public Health, Imperial College London, London, UK
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Richard J Pinder
5 Consultant in Public Health Medicine, Department of Primary Care and Public Health, Imperial College London, London, UK
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  • Figure 1.
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    Figure 1. Absolute total number of prescriptions (in millions) of gabapentin, pregabalin, and oxycodone made in primary care per year.
  • Figure 2.
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    Figure 2. GIS visualisation of CCG’s mean rate of prescribing of a) gabapentin, b) pregabalin, and c) oxycodone. Missing CCGs are given in white and are excluded due to boundary changes or mergers that occurred during the time period of the study (n = 187).

    CCG = clinical commissioning group. GIS = geographic information system.

    © Crown copyright and database rights 2019. Ordnance Survey (0) 100019252

Tables

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    Table 1. Total number of GP practices in England and number of GP practices included in this study
    20132014201520162017
    Number of GP practicesa 81068002781676807492
    Number of GP practices included 71327029690767286632
    • aTotal number extracted from NHS Digital GP practice demographics.

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    Table 2. Median GP practice list size, median rate of gabapentin, pregabalin, and oxycodone prescriptions per 1000 population per GP practice
    2013
    Median (95% CI)
    2014
    Median (95% CI)
    2015
    Median (95% CI
    2016
    Median (95% CI)
    2017
    Median (95% CI)
    GP practice list size 5022 (4899 to 5096)5100 (4935 to 5141)5283 (5096 to 5300)5478 (5285 to 5485)5760 (5538 to 5772)
    Gabapentin prescriptions per 1000 population 83.6(82.4 to 85.3)98.7 (97.2 to 100.4)113.3 (110.9 to 115.4)127.2 (124.7 to 129.7)136.2 (133 .3 to 138.5)
    Pregabalin prescriptions per 1000 population 65.8 (64.3 to 66.8)79.8 (78.6 to 81.4)92.9 (91.2 to 94.9)106.9 (104.9 to 108.8)118.6 (116.8 to 120.2)
    Oxycodone prescriptions per 1000 population 2.1 (2.0 to 2.1)2.3 (2.2 to 2.3)2.5 (2.4 to 2.7)2.7 (2.6 to 2.8)2.8 (2.8 to 2.9)
    • View popup
    Table 3. Association between number of prescriptions per person per GP practice and GP practice IMD quintile
    GabapentinPregabalinOxycodone
    Univariate RR 95% CI P value RR (95% CI) P value RR P value
    IMD quintile    
    (least deprived) 11 (Ref)Ref1 (Ref)Ref1 (Ref)Ref
    21.26 (1.22 to 1.31)<0.0011.2 (1.16 to 1.24)<0.0011.19 (1.13 to 1.25)<0.001
    31.53 (1.48 to 1.58)<0.0011.35 (1.31 to 1.40)<0.0011.37 (1.31 to 1.44)<0.001
    41.8 (1.745 to 1.86)<0.0011.56 (1.51 to 1.61)<0.0011.47 (1.40 to 1.54)<0.001
    (most deprived) 52.29 (2.22 to 2.37)<0.0011.86 (1.80 to 1.92)<0.0011.71 (1.63 to 1.80)<0.001
    Multivariate       
    IMD quintile    
    (least deprived) 11 (Ref)Ref1 (Ref)Ref1 (Ref)Ref
    21.24 (1.21 to 1.28)<0.0011.2 (1.16 to 1.23)<0.0011.2 (1.15 to 1.25)<0.001
    31.59 (1.54 to 1.63)<0.0011.39 (1.35 to 1.44)<0.0011.47 (1.40 to 1.53)<0.001
    42.12 (2.06 to 2.18)<0.0011.79 (1.74 to 1.845)<0.0011.82 (1.74 to 1.90)<0.001
    (most deprived) 53.13 (3.04 to 3.23)<0.0012.38 (2.30 to 2.45)<0.0012.54 (2.42 to 2.66)<0.001
    Year    
    20131 (Ref)Ref1 (Ref)Ref1 (Ref)Ref
    20141.2 (1.175 to 1.22)<0.0011.24 (1.21 to 1.26)<0.0011.11 (1.07 to 1.14)<0.001
    20151.36 (1.33 to 1.38)<0.0011.42 (1.40 to 1.45)<0.0011.19 (1.16 to 1.22)<0.001
    20161.51 (1.48 to 1.54)<0.0011.62 (1.59 to 1.655)<0.0011.26 (1.225 to 1.30)<0.001
    20171.55 (1.525 to 1.58)<0.0011.75 (1.72 to 1.79)<0.0011.27 (1.23 to 1.31)<0.001
    Sex    
    % female1 (0.10 to 1.00)0.0881 (0.10 to 1.00)0.2011.02 (1.02 to 1.03)<0.001
    Age    
    % ≥65 years1.04 (1.04 to 1.04)<0.0011.03 (1.03 to 1.03)<0.0011.04 (1.04 to 1.04)<0.001
    • IMD = Index of Multiple Deprivation. Ref = reference. RR = rate ratio.

    • View popup
    Table 4. CCGs with the highest total number of gabapentin, pregabalin, and oxycodone prescriptions per 1000 population in 2017/2018.
    GabapentinPregabalinOxycodone
    CCG Number of prescriptions (per 1000 population) CCG Number of prescriptions (per 1000 population) CCG Number of prescriptions (per 1000 population)
    NHS Hardwick370.2NHS Durham Dales, Easington and Sedgefield283.9NHS Hull129.0
    NHS Blackpool370.1NHS Darlington283.6NHS Salford91.0
    NHS Durham Dales, Easington and Sedgefield369.8NHS Lincolnshire East283.6NHS Blackburn with Darwen87.8
    NHS Sunderland350.7NHS South Tees274.8NHS Sunderland83.6
    NHS Salford345.9NHS Sunderland272.8NHS Thanet81.7
    • CCGs that did not exist in 2013/2014 and 2017/2018 are excluded from this data set. CCG = clinical commissioning group.

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Prescribing trends of gabapentin, pregabalin, and oxycodone: a secondary analysis of primary care prescribing patterns in England
Katlyn Green, Nora Cooke O'Dowd, Hilary Watt, Azeem Majeed, Richard J Pinder
BJGP Open 2019; 3 (3): bjgpopen19X101662. DOI: 10.3399/bjgpopen19X101662

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Prescribing trends of gabapentin, pregabalin, and oxycodone: a secondary analysis of primary care prescribing patterns in England
Katlyn Green, Nora Cooke O'Dowd, Hilary Watt, Azeem Majeed, Richard J Pinder
BJGP Open 2019; 3 (3): bjgpopen19X101662. DOI: 10.3399/bjgpopen19X101662
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Keywords

  • Oxycodone
  • gabapentin
  • pregabalin
  • prescribing
  • misuse

More in this TOC Section

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