{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:32:27Z","timestamp":1793251947003,"version":"4.5.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230569-4\"><jats:title>Importance<\/jats:title><jats:p>In response to the opioid epidemic, recommendations from some pain societies have encouraged surgeons to embrace multimodal pain regimens with the intent of reducing opioid use in the postoperative period, including by prescribing gabapentinoids.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-5\"><jats:title>Objective<\/jats:title><jats:p>To describe trends in postoperative prescribing of both gabapentinoids and opioids after a variety of surgical procedures by examining nationally representative Medicare data and further understand variation by procedure.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This serial cross-sectional study of gabapentinoid prescribing from January 1, 2013, through December 31, 2018, used a 20% US Medicare sample. Gabapentinoid-naive patients 66 years or older undergoing 1 of 14 common noncataract surgical procedures performed in older adults were included. Data were analyzed from April 2022 to April 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-7\"><jats:title>Exposure<\/jats:title><jats:p>One of 14 common surgical procedures in older adults.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Rate of postoperative prescribing of gabapentinoids and opioids, defined as a prescription filled between 7 days before the procedure and 7 days after discharge from surgery. Additionally, concomitant prescribing of gabapentinoids and opioids in the postoperative period was assessed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-9\"><jats:title>Results<\/jats:title><jats:p>The total study cohort included 494\u202f922 patients with a mean (SD) age of 73.7 (5.9) years, 53.9% of whom were women and 86.0% of whom were White. A total of 18\u202f095 patients (3.7%) received a new gabapentinoid prescription in the postoperative period. Of those receiving a new gabapentinoid prescription, 10\u202f956 (60.5%) were women and 15 529 (85.8%) were White. After adjusting for age, sex, race and ethnicity, and procedure type in each year, the rate of new postoperative gabapentinoid prescribing increased from 2.3% (95% CI, 2.2%-2.4%) in 2014 to 5.2% (95% CI, 5.0%-5.4%) in 2018 (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). While there was variation between procedure types, almost all procedures saw an increase in both gabapentinoid and opioid prescribing. In this same period, opioid prescribing increased from 56% (95% CI, 55%-56%) to 59% (95% CI, 58%-60%) (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Concomitant prescribing also increased from 1.6% (95% CI, 1.5%-1.7%) in 2014 to 4.1% (95% CI, 4.0%-4.3%) in 2018 (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230569-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The findings of this cross-sectional study of Medicare beneficiaries suggest that new postoperative gabapentinoid prescribing increased without a subsequent downward trend in the proportion of patients receiving postoperative opioids and a near tripling of concurrent prescribing. Closer attention needs to be paid to postoperative prescribing for older adults, especially when using multiple types of medications, which can have adverse drug events.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.18626","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T15:34:38Z","timestamp":1686929678000},"page":"e2318626","source":"Crossref","is-referenced-by-count":29,"title":["Trends in the Use of Gabapentinoids and Opioids in the Postoperative Period Among Older Adults"],"prefix":"10.1001","volume":"6","author":[{"given":"Tasce","family":"Bongiovanni","sequence":"first","affiliation":[{"name":"Department of Surgery, University of California, San Francisco, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Gan","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, University of California, San Francisco, School of Medicine"},{"name":"Northern California Institute for Research and Education, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Finlayson","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California, San Francisco, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S.","family":"Ross","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2013New Haven Hospital, New Haven, Connecticut"},{"name":"Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Department of Health Policy and Management, Yale University School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, University of California, San Francisco, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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