Prescribing patterns for treating common complications of spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1920786 · Published: January 1, 2023

Spinal Cord Injury Pharmacology Healthcare

Simple Explanation

This study examines medication use among individuals with spinal cord injuries (SCI) in Canada, focusing on polypharmacy, which is defined as taking more than 5 medications concurrently. The research identifies the most and least commonly prescribed drugs for treating secondary health conditions related to SCI, such as pain, muscle spasms, and urinary tract infections. The findings aim to raise awareness among healthcare providers about medication use in SCI patients, potentially leading to better prescribing practices and improved patient communication.

Study Duration

Not specified

Participants

108 individuals with spinal cord injury

Evidence Level

Observational design, cross-sectional analysis

Key Findings

1
The most commonly treated conditions among SCI patients were pain (56.5%), muscle spasms (54%), and urinary tract infections (43%).
2
Anti-convulsants (pregabalin, gabapentin), anti-spasmodics (baclofen, diazepam) and nitrofurantoins (Macrobid) were the most commonly prescribed medications to treat each of the three conditions, respectively.
3
A significant portion of the sample (35%) received a combination of two or more analgesics, including fourth-line agents like hydromorphone and morphine.

Research Summary

This study aimed to identify polypharmacy rates, risk factors, and commonly prescribed medications among individuals with SCI to inform medication management practices. The study found that 45% of individuals with SCI experience polypharmacy, and there were no significant associations between polypharmacy and demographic or SCI-related characteristics. The most common complications requiring pharmacological treatment were pain, urinary tract infections, and muscle spasms, with some prescribing patterns deviating from standard clinical practice guidelines.

Practical Implications

Improved Prescribing Practices

Healthcare providers can use the findings to identify potentially inappropriate medications and deprescribe them effectively and safely.

Enhanced Patient Communication

Patients can improve communication with their prescribers for better medication management.

Development of Clinical Guidelines

The study highlights the need for SCI-specific clinical management guidelines to aid general physicians in prescribing appropriate medications.

Study Limitations

1
The study relies on self-reported data without validation from medical records.
2
The cross-sectional design does not capture changes in prescribing patterns over time.
3
The recruitment process involved voluntary participation, potentially limiting the representativeness of the sample.

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