Strategies for Rotation between Gabapentinoids in the Inpatient Setting
| Autor: | Madison N. Irwin, Kyle Quirk, Michael A. Smith, Andrea Banner, Kevin Hosseini |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Pregabalin 03 medical and health sciences Normal renal function chemistry.chemical_compound 0302 clinical medicine Primary outcome Internal medicine Post-hoc analysis medicine Humans Pharmacology (medical) 030212 general & internal medicine Adverse effect Retrospective Studies Inpatients business.industry Retrospective cohort study Inpatient setting Middle Aged Hospitalization Anesthesiology and Pain Medicine chemistry Gabapentin business 030217 neurology & neurosurgery medicine.drug Gabapentinoid |
| Zdroj: | Journal of Pain & Palliative Care Pharmacotherapy. 35:13-22 |
| ISSN: | 1536-0539 1536-0288 |
| DOI: | 10.1080/15360288.2020.1852358 |
| Popis: | Guidance and evidence to support best practices in rotating between gabapentinoids is lacking. This retrospective cohort study was performed to describe and evaluate strategies for rotation. Patients rotated while admitted from June 1st, 2014 to April 25th, 2020 at a large, academic medical center were included. The primary outcome was the proportion of rotations using a direct switch strategy compared to a cross-taper strategy. Secondary outcomes were successful rotation, defined as stable or improved pain scores pre- to post-rotation, dose ratios, and adverse effects. A total of 67 patients were included. Median age was 50 years (35 - 59) and 58% (38) were male. The majority used a direct switch strategy (87%). Ninety-five percent of patients using the direct switch strategy and 78% of patients using the cross-taper strategy were successful. There was no difference in strategies between those who were successful and those who were not. Post hoc analysis of patients with normal renal function (eGFR ≥ 50 mL/min/1.73 m2) found that those who were successful were more likely to have used a direct switch strategy (p = 0.048). There were no differences in adverse effects. These findings suggest that either strategy is reasonable for gabapentinoid rotation in the inpatient setting. |
| Databáze: | OpenAIRE |
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