Category: Federal Forum Posters
Purpose: Pregabalin is approved for diabetic neuropathy, neuropathic pain associated with spinal cord injury, epilepsy, and postherpetic neuralgia. Studies show twice-daily dosing is as efficacious as thrice-daily dosing. In 2016, pregabalin was added to the Veteran Affairs (VA) national formulary with criteria for use. All capsule strengths are available at a flat price. In 2018, pharmacists contacted primary care providers to convert outpatient pregabalin prescriptions for pain management to twice-daily dosing as a VA Connecticut cost-savings initiative. The purpose of this quality improvement study is to evaluate effectiveness of the twice-daily dosing conversion and prescribing appropriateness since addition to the formulary.
Methods: A retrospective chart review of all veterans at VA Connecticut who were on more than two capsules per day and subsequently converted to twice-daily dosing will be conducted. Eligible patients must be on the new regimen for at least 6 weeks (42 days) at time of analysis. Patients with indication of anxiety or seizure will be excluded. Information will be retrieved from the electronic medical record. Patient demographic information including age, gender, and renal function will be recorded. Pregabalin indication and dose, existence of a prior non-formulary approval, and length of time patient has been taking twice-daily dosing at time of evaluation will be collected. Additionally, if patient remains on twice-daily dosing, patient discontinued pregabalin, dose was increased, notes document worsened pain control, or if patient had additional appointments or telephone calls to their provider for worsened pain will be documented. The primary endpoint of this study is efficacy of twice-daily pregabalin dosing in pain management, measured by the percentage of patients who remain on twice-daily regimen and did not report worsened pain. Secondary endpoints will describe appropriate prescribing at VA Connecticut since addition to the national formulary and pain control specifically in patients prescribed pregabalin for chronic back pain.
Results: Not applicable
Conclusion: Not applicable
Casandra Holveck– PGY1 Pharmacy Resident, VA Connecticut Healthcare System, Milford, CT