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Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non-cancer pain: a five-year prospective cohort study

journal contribution
posted on 2023-05-20, 20:51 authored by Nielsen, S, Gisev, N, Leung, J, Clare, P, Raimondo BrunoRaimondo Bruno, Lintzeris, N, Larance, B, Blyth, F, Hall, W, Cohen, M, Degenhardt, L, Farrell, M, Campbell, G
Aims: Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic non-cancer pain, but few studies have examined its clinical efficacy outside trials. We address this gap by examining the utilization, correlates and clinical outcomes of pregabalin use among an Australian community-based cohort of people prescribed opioids for chronic non-cancer pain.

Methods: Through a five-year prospective cohort study (n = 1514) we examined associations between pregabalin use and pain severity and interference, mental health, opioid dose and past month use of ambulance and emergency department services. We used fixed-effects regression models to examine within-participant differences, and random-effects regression models to examine within- and between participant differences in clinical outcomes.

Results: In an analysis of cases with complete data over five-years (n = 896), the prevalence of pregabalin use ranged from 16% at cohort entry to 29% at 36- and 48-months, and 46% reported pregabalin use at any time during the five years. Pregabalin use was associated with greater pain severity and interference and greater use of high-risk opioid doses (>90 oral morphine equivalents/day). Pregabalin use was not associated with changes in mental health symptoms, ambulance or emergency department attendance in the fixed or random effects models.

Conclusions: Pregabalin use was common, but for most people use was not associated with clinically meaningful improvements in pain or functioning.


Publication title

British Journal of Clinical Pharmacology






School of Psychological Sciences


Blackwell Publishing Ltd

Place of publication

9600 Garsington Rd, Oxford, England, Oxon, Ox4 2Dg

Repository Status

  • Restricted

Socio-economic Objectives

Substance abuse

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