Evaluating health-related quality of life and health resource utilization among Gabapentinoid users with substance use disorder in the US: Trends, co-prescriptions, and cost analysis

Abstract

Background

Gabapentinoid, including Gabapentin and Pregabalin, are commonly used for approved and off-label health conditions, but their misuse with opioid among individuals with substance use disorder (SUD) increases the risk of respiratory depression and death. Thus, we investigated the impact of SUD on different health outcomes among the Gabapentinoid users in the U.S.

Methods

We used Medical Expenditure Panel Survey data (2015 to 2021) to identify Gabapentinoid users and categorized them into SUD and Non-SUD groups. The primary aim was to investigate the association between SUD and health related quality of life measured through physical component score (PCS) and mental component score (MCS) while secondary aim was to compare healthcare utilization between these groups. The prescription trends and related costs were also examined.

Results

Total 164 Gabapentinoid users had SUD who had lower MCS compared to the Non-SUD group (β = −3.83 [−6.24, −1.41], p = 0.002). Additionally, SUD was associated with a higher number of outpatient visits (β = 0.35 [0.02, 0.68], p = 0.04). The SUD group incurred higher total expenditure ($10,671.4, SE = 970.6) compared to the Non-SUD group ($9166.7, SE = 714.7). Gabapentinoid use increased from 2015 to 2021, with Pregabalin prescriptions rising from 0.98 % to 2.24 % and Gabapentin from 4.37 % to 10.16 %. Among users with SUD, common co-prescriptions included Tramadol (46.59 %), Oxycodone (35.62 %), and Lorazepam (34.78 %).

Conclusion

Our results suggest the critical need to monitor and assess the Gabapentinoid prescription among individuals with SUD, further warrant to develop and implement new policies and guidelines at both federal and state levels in the U.S.