The attitudes of Turkish physicians in the treatment of fibromyalgia; is “Pregabalinophobia” the new reality of pain medicine?
Sertaç Ketenci1
, Birzat Emre Gölboyu2, Ender Salbaş3, Bora Uzuner4, Bahadır Çiftçi5
1Department of Rheumatology, Manisa City Hospital, Manisa, Türkiye
2Department of Pain, Manisa City Hospital, Manisa, Türkiye
3Department of Physical Medicine and Rehabilitation, Ömer Halisdemir University Faculty of Medicine, Niğde, Türkiye
4Department of Physical Medicine and Rehabilitation, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
5Department of Anesthesiology and Reanimation, Medipol University, İstanbul, Türkiye
Keywords: Drug abuse, fibromyalgia, pregabalin, pregabalinophobia.
Abstract
Objectives: This study aims to determine the treatment preferences of physicians interested in fibromyalgia treatment and to investigate their hesitations about prescribing pregabalin.
Methods: Our survey study was conducted between February 5 and 20, 2021. The survey forms were sent to the known email addresses and phone numbers of 1569 physical medicine and rehabilitation (PMR), algology, and rheumatology physicians. The replies to the surveys were checked for possible resubmissions. The pooled data were evaluated with the SPSS 22.0 statistical package program. Frequency distributions were calculated and presented as n, %.
Results: Four hundred and six PMR, rheumatology, and algology specialists fulfilled the study forms. About 59.0% of physicians stated that they prefer duloxetine as the first-line agent of fibromyalgia syndrome (FMS) treatment. Pregabalin was only 6.0% of the physicians’ first choice for FMS. About 35.0% of the participating physicians stated that the PMR department should follow up FMS patients. About 44.3% of the participants noted that they refer FMS patients to other departments which interested in FMS treatment and do not want to follow-up FMS patients. About 81% agreed that pregabalin causes addiction. About 36.7% stated that at least 20% of the patients could abuse pregabalin and 97.8% of physicians stated that they were prejudiced about prescribing pregabalin to prisoners. Approximately two of the three physicians experienced an act of violence in their hospital regarding pregabalin prescribing.
Conclusion: These data showed that the “Pregabalinophobia” should be accepted. This condition is associated with life safety concerns of the physician not only from unreliability of the drug. It seems that the doctors have valid reasons to develop this prejudice.