COMPARATIVE EFFECTS OF GABAPENTINOIDS VS OPIOIDS ON FRAILTY AND PHYSICAL FUNCTION AMONG MEDICARE BENEFICIARIES

The use of opioids in the treatment of chronic non-cancer pain has been the standard pharmacological option for many years. With the concern over the opioid epidemic, effective pain relief alternatives have been sought. Recently, gabapentinoids have increased in use, specifically as a substitute for opioids in those with chronic non-cancer pain. The aim of this dissertation was to evaluate the patterns of gabapentinoid use among long-term opioid users and assess the comparative effectiveness against opioids in changes in frailty and physical function, using a national sample of Medicare beneficiaries. First, we examined the patterns of new long-term opioid users who were switching to or supplementing their opioids with gabapentinoids. We found that there were differences in gabapentinoid use by age, race/ethnicity, pain locations, and opioid dosage during the long-term use period. Second, we assessed the effectiveness of gabapentinoids at mitigating the increase in frailty over time. We found that gabapentinoids did not improve frailty over time, were associated with a greater increase in frailty compared to no drug use, and were not different from opioids in mitigating the increases in frailty. Third, we examined the relationship between gabapentinoid use and changes in physical function among home health care beneficiaries. This aim found that, while gabapentinoids improved physical function more than no drugs, they were less effective than opioids in improving overall function. Overall, we found that gabapentinoids at best had equal outcomes compared to opioids in pain-related outcomes, and at worst were less effective than opioids. These findings highlight the importance of thoughtful decision making regarding which medications to prescribe in the treatment of chronic non-cancer pain.

Name thesis:degree_name

Clinical Science (Doctoral)

Discipline thesis:degree_discipline

Health Services Research

Grantor

The University of Texas Medical Branch at Galveston

Year dc:date.issued

2024

Author dc:creator

• Westra, Jordan Russell 1990-

Advisor dc:contributor.advisor

• Kuo, Yong-Fang (yokuo@utmb.edu)

Committee members dc:contributor.committeemember

• Baillargeon, Jacques (jbaillar@utmb.edu)
• Raji, Mukaila (muraji@utmb.edu)
• Li, Chih-ying (chili@utmb.edu)
• Aparasu, Rajender (raparasu@central.uh.edu)

Language dc:language.iso

English

Handle dc:identifier.uri

https://hdl.handle.net/2152.3/12782

OAI identifier oai:identifier

oai:utmb-ir.tdl.org:2152.3/12782