Evaluating and Developing Quality Metrics Regarding the Concomitant Use of Opioids and Gabapentinoids

Abstract

Background: The opioid epidemic was declared in 2017, and the Centers for Medicare & Medicaid Services (CMS) aimed to gather information to compose an evidence-based guideline that protects patients and decreases opioid abuse. Objective(s): The purpose of this project was to evaluate gabapentinoids combined with opioids to determine if there is sufficient evidence of opioid potentiation to support the development of opioid quality metrics regarding their concomitant use. Methods: This was a retrospective literature review project of 5 articles related to gabapentinoids potentiating the effects of opioids. A search of articles involving the use of opioids and gabapentinoids was conducted utilizing an online academic search engine. The following limiters were applied to all searches: peer reviewed, full text, libraries worldwide, and published between 2008-2018. Results: Based upon the analysis of the 5 gabapentinoid articles, a quality metric limiting milligrams per day of gabapentin is recommended. The maximum dosage of gabapentin should not exceed 900 milligrams per day due to the evidence of increased death and respiratory depression that occurs at increased dosages. There needs to further research conducted regarding Lyrica and opioids. Conclusions: The implementation of a standardized quality metric related to gabapentinoids and opioids would assist in identification of potentially hazardous prescribing patterns and monitoring of patient care.