gms | German Medical Science

Hintergrund/Fragestellung: StatisticAustria reports a continuous increase in the age of the Austrian population leading to multimorbidity and polypharmacy. Nevertheless, the elderly are underrepresented in studies on drug effectiveness and safety besides well-known age-related differences in pharmacokinetics. Therefore, drug treatment may carry elevated risks for older patients. This led to the development of the first list of Potentially Inappropriate Medication (PIM) by Beers in 1991 and subsequently to national and international lists in several countries and regions. Pregabalin is the most frequently prescribed drug for neuropathic pain, often found in elderly patients, especially those with diabetes mellitus type 2. However, pregabalin HHhPregabalin Pwas classified as PIM in Austria 2012 by expert opinion in a delphi process due to possible severe adverse events. The objective of this review is to base the classification of pregabalin as PIM on reliable evidence derived from studies rather than mere expert opinion for the upcoming update of the Austrian PIM list.

Methoden: The search terms for Pregabalin as well as the inclusion and exclusion criteria are generated using the PICOS scheme. Following the database search, relevant studies will be selected in a 2-step review process, first by title/abstract and then on the full manuscript level by two independent reviewers. Data from included studies will be extracted into prespecified data extraction tables. After quality appraisal according to Cochrane methodology, meta-analyses will be performed if comparable papers (e.g. similar research questions and outcomes) are available. Alternatively, the obtained results will be discussed in a descriptive-narrative way. Finally, evidence based recommendations will be drawn regarding the prescription of pregabalin for the elderly using GRADE methodology.

Ergebnisse: The search has been carried out in the PubMed (Medline and the EMASE databases as well as the Cochrane Database of Systematic Reviews and yielded 837 hits. Study selection and data extraction are currently under way. Final results will be available at the conference.

Schlussfolgerung: The recommendations derived from this systematic review will contribute to evidence based prescription of drugs in old patients. It also will improve patient safety and specifically the safety of drug treatment in elderly patients. By preventing adverse events a reduction in health care costs may also be expected.

Interessenkonflikte: This study is funded by the Hauptverband der österreichischen Sozialversicherungsträger.