Prescribing of gabapentin and pregabalin (DDD)

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Total DDD of pregabalin + gabapentin per 1000 patients
Why it matters Gabapentin and pregabalin are increasingly used in neuropathic and other types of pain, and use is rising rapidly in the NHS. There are also concerns about the potential for abuse and consequently both medicines have been reclassified legally (more information here). There appears to be no robust evidence for dose conversion between gabapentin and pregabalin. We have therefore chosen to use the Defined Daily Dose (DDD) for this measure. This is a similar dose ratio that Toth described in his paper on the substitution of gabapentin with pregabalin.

Please note that this is an experimental measure. We would be grateful for any feedback at [email protected]
Tags Standard, Pain, Safety
Implies cost savings No
Authored by richard.croker
Checked by brian.mackenna
Last reviewed 2019-06-25
Next review due 2020-01-03
Associated notebook https://github.com/ebmdatalab/jupyter-notebooks/blob/master/new_measures/New%20Measure%20-%20Gabapentin%20and%20Pregabalin%20DDD.ipynb
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(gaba_ddd) AS numerator
 FROM measures.gaba_total_ddd
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(total_list_size / 1000.0) AS denominator
 FROM hscic.practice_statistics
 GROUP BY month, practice_id