Odds of Gabapentin Rx Down for Adults With LBP Receiving Spinal Manipulation

MONDAY, July 31, 2023 (HealthDay News) -- Adults receiving chiropractic spinal manipulative therapy (CSMT) for newly diagnosed radicular low back pain (rLBP) have significantly reduced odds of receiving a gabapentin prescription during one-year follow-up, according to a study published in the July issue of BMJ Open.

Robert J. Trager, D.C., from the University Hospitals Cleveland Medical Center, and colleagues conducted a retrospective cohort study involving linked medical records, medical claims, and pharmacy claims of more than 122 million patients attending large health care organizations to examine the association between CSMT and gabapentin prescription for adults with rLBP. Adults aged 18 to 49 years were included at first diagnosis of rLBP. After propensity matching, 1,635 patients were included in the CSMT cohort and the usual medical care cohort.

The researchers found that during one-year follow-up, gabapentin prescription was significantly lower in the CSMT versus usual medical care cohort, with an odds ratio of 0.53. Early divergence in cumulative incidence of prescription was seen in a sensitivity analysis; in a negative control outcome (gastrointestinal medication), there was no significant between-cohort difference observed, suggesting adequate control for pharmacologic care preference.

"These findings are consistent with a potential influence of early CSMT on patients' rLBP care pathway towards avoiding certain prescription medications," the authors write. "However, our findings may not be generalizable to smaller practice settings or other countries."

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