Objective:

To estimate the prevalence and correlates of gabapentinoid prescriptions among older adults presenting with acute ischemic stroke (AIS).

Background:

Little is known about patterns of gabapentinoid use among older adults hospitalized for stroke, who are more vulnerable to side effects.

Design/Methods:

We conducted a retrospective analysis of 2009-2022 claims data from a 20% sample of U.S. Medicare beneficiaries aged 65 years and older hospitalized for AIS. We included patients without prior stroke enrolled in traditional Medicare Parts A, B, D coverage for 12 or more months before hospitalization. We analyzed gabapentinoid prescription claims 6 months prior to AIS hospitalization, estimating prevalent users by year, U.S. census division, and age group.

Results:

Among 271,011 beneficiaries hospitalized for AIS between 2009 and 2022, 32,237 (11.9% [95% CI: 11.8 – 12.0]) had gabapentinoid prescription claims prior to hospitalization. Median age was 79 (Quartile Range: 73 – 86), 60% were women, and 80% were Non-Hispanic White. Prevalent gabapentinoid users increased from 8.5% [95% CI: 8.2 – 8.9] in 2009 to 13.7% [95% CI: 13.0 – 14.5] in 2022. The largest prevalence rate difference between U.S. Census divisions was observed for the Mid-Atlantic (9.4% [95% CI: 9.1 – 9.7]) division vs. the East South-Central division (14.9% [95% CI: 14.5 –  15.4]). Prevalent gabapentinoid use decreased with advancing age group, with 15.6% [95% CI: 15.2  – 15.9] prevalent use among 65-69 year-olds and 9.6% [95% CI: 9.4 – 9.8] among 85+ year-olds.

Conclusions:

Many Medicare beneficiaries hospitalized for AIS were using gabapentinoids preadmission. The prevalence rate increased between 2009 and 2022 and varied significantly by geographic region.