Background: Pregabalin is indicated for neuropathic pain associated with diabetic peripheral neuropathy (DPN), post herpetic neuralgia (PHN), adjuvant therapy for adult patients with partial onset seizures and fibromyalgia. Pregabalin binds to the α2δ subunits of the voltage-gated calcium channels in central nervous system tissues. Pregabalin elimination is proportional to creatinine clearance. Pregabalin clearance is reduced in patients with impaired renal function. National Health Insurance issues the maximum dose of pregabalin for DPN is 300mg once daily, PHN is 600mg once daily and fibromyalgia is 450mg once daily.
Objectives: This study explores the rationality of using pregabalin.
Methods: This is a retrospective study in a regional hospital in central Taiwan. Cases were collected from January 2018 to October 2018 for all outpatients using pregabalin. The reasonableness assessment of pregabalin prescribing included indications, maximum dose and dose adjustment for renal function impairment. Descriptive statistical analysis was performed in the study.
Results: Total 495 cases were recruited in the study. 201 cases (40.6%) conformed to National Health Insurance guidance, and 294 cases (59.4%) did not conform it. 272 (54.9%) of them have no relevant indication. A total of 4 cases (0.81%) with unadjusted doses for renal dysfunction (GFR <30mL/min).
Conclusions: This study showed that the improper use of pregabalin was 294 cases (59.4%). This was result of miscoding of ICD9 corresponding to ICD10 diagnostic code. Therefore, the computerized physician order entry (CPOE) system was revised. This study demonstrated the pharmacist- intervention and collaboration with the physician reduced the medical expenses.
