Research ArticleResearchMedication Safety

Among older surgical patients with a new gabapentinoid prescription, 38% had prolonged use after skilled nursing

Journal of the American Geriatrics Society (PubMed)Jul 11, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

In Medicare data for 79,417 older surgical patients discharged through skilled nursing before going home, 4% received a new gabapentinoid prescription and 38% of those new users had prolonged use.

What NurseJet pulled from the source

Researchers linked Medicare hospital, outpatient, clinician, and Part D data from 2013 through 2020 to examine gabapentinoid use after 14 common operations in adults aged 66 or older who moved from the hospital to a skilled nursing facility and then home. Among 79,417 patients, the median skilled-nursing stay was 15 days. A total of 3,182 patients (4%) received a new gabapentinoid prescription, and 1,219 of those new users (38%) met the study definition of prolonged use. Female sex, gabapentinoid days' supply, emergency surgery, nonorthopedic and nonvascular surgery, and greater area deprivation were associated with prolonged use in adjusted analysis. The authors found that prolonged use was more common than previously reported among patients discharged directly home and called for more work on medication continuation after skilled-nursing discharge. The claims-based design did not determine whether an individual patient's prolonged use was clinically appropriate.

Why this matters for nurses

A medication started around surgery can follow a patient across hospital, skilled-nursing, and home settings, making its original purpose and intended duration easy to lose. This study matters for nurses because medication reconciliation and clear handoff documentation can make a new gabapentinoid visible for review at each transition.

Bedside takeaway

Be aware that 38% of the older surgical patients newly prescribed a gabapentinoid during a hospital-to-skilled-nursing-to-home transition had prolonged use, a persistence signal that warrants reconciliation without assuming inappropriateness.

Key takeaways

The cohort included 79,417 Medicare patients aged 66 or older who underwent one of 14 operations and transitioned through skilled nursing before returning home.
New gabapentinoid use occurred in 3,182 patients, or 4% of the full cohort.
Among those newly prescribed a gabapentinoid, 1,219 patients, or 38%, had prolonged use.
The study describes prescribing persistence and associated factors but does not establish that prolonged use was inappropriate.

Practice implications

During medication reconciliation, nurses can clarify and document when a gabapentinoid was started, its current indication, and whether continued use remains intended, then route uncertainty through the prescriber or pharmacist. The study does not support labeling every prolonged prescription inappropriate or independently stopping a patient's medication.

Limitations & cautions

This retrospective claims analysis used 2013 to 2020 Medicare data and cannot establish why a prescription continued or whether continued use was appropriate. It may not generalize to younger patients or newer prescribing patterns, and associations with prolonged use do not establish that the identified factors caused it.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Journal of the American Geriatrics Society (PubMed)

Journal of the American Geriatrics Society (PubMed). Prolonged Use of Postoperative Gabapentin After Discharge From a Skilled Nursing Facility.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42435316/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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AI-summarized from the linked source. Review the original article before applying to practice.

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