Barriers and facilitators to the prescribing and use of medicines to manage neuropathic pain in primary care settings in the United Kingdom: a mixed methods study

Comfort Mshelia, University of Leeds

Neuropathic pain, NP, which is pain arising due to injury to the nerves, affects about 8% of people in the UK. There are different types of NP depending on which part of the nervous system is affected. There is no cure for NP; people who get it will likely have it for the rest of their lives. Medicines can be used to manage the symptoms of NP and reduce the pain they feel. Although many different classes of medicines that have been shown to be effective in the management of NP, 20-40% of patients either experience less than 30% reduction in their pain or have unbearable side effects. In the UK, there is guidance on the specific medicines that can be prescribed in primary care settings and those which can only be initiated by specialists. Previous studies exploring prescribing patterns for this group of patients in the UK have shown that prescribers often switch patients to other classes of medicines several times before a suitable treatment is found. In addition to this, there is a heavy dependence on analgesics such as Non-steroidal Anti-inflammatory Drugs, NSAIDs, and opioids even though there is no strong evidence of their usefulness in managing NP. The recent rise in the risk of addiction to Gabapentinoids including gabapentin and pregabalin as well as increasing deaths associated with these medicines, especially when the patient takes opioids as well raises concerns regarding the prescribing of these medicines for patients with NP. There is therefore a need to undertake this study, to update our knowledge on the prescribing patterns and use of medicines used to manage NP conditions with a view to highlighting areas for improvement of prescribing practices as well as patient use in order to increase patient safety.

This project is running from 01/10/2019 and is due to finish on 30/06/2021