Category: Federal Forum Posters
Purpose: Gabapentin is an anticonvulsant widely used in the management of pain. With sole kidney elimination, as renal clearance declines, higher plasma concentrations and reduced elimination can occur. Failure to account for this can lead to serious toxicity including ataxia, nystagmus, drowsiness, fatigue, and myoclonic twitches. As elderly patients more frequently have decreased renal function, care should be taken in dose selection with dose adjustment based on creatinine clearance (CrCl). The purpose of this medication use evaluation is to assess the incidence of gabapentin dosing above dose recommendations in patients with compromised renal function at Bay Pines VA Healthcare System (BPVAHCS).
Methods: This medication utilization review was reviewed by the BPVAHCS Research and Development Service and was deemed a quality improvement project. Patients at the BPVAHCS with an active prescription as of August 1st, 2018 for gabapentin and CrCl less than 60 ml/min will serve as the medication use evaluation study population. CrCl will be estimated using the equation of Cockcroft-Gault. A cross-sectional data analysis will be completed to stratify patients who meet the aforementioned criteria. Up to two-hundred patients will be randomly selected for review. Data will be collected and de-identified in an excel spreadsheet within a controlled access folder. Using the information collected, Veterans receiving gabapentin at a dose outside of the recommendations established by the Food and Drug Administration (FDA) may be identified. This information will serve as a basis for future quality improvement projects to help reduce the incidence of gabapentin dosing above recommendations within the Bay Pines Veteran population.
Results: Not applicable
Conclusion: Not applicable
Katelyn Shatz– PGY1 Resident, Bay Pines VA HealthCare System, St. Petersburg, FL