Introduction Pregabalin is commonly used for the treatment of neuropathic pain. Costs to primary care providers can be up to -£1255 per patient per year.

Objectives Audit undertaken at South London GP surgery (Bermondsey and Lansdowne Medical Missions (BLM2) to assess if prescribing of Pregabalin in neuropathic pain is clinically appropriate and in line with NICE and South London Area Prescribing Committee guidance. Patients switched to cheaper first line alternatives or medication stopped where clinically appropriate.

Method Patients included males and females on repeat prescriptions of Pregabalin for neuropathic pain from April 2014 to January 2015 (47 in total). Audit information obtained from electronic patient records (EMIS). Clinical code created to flag patients on computer system who required review. Audit loop closed 1 year later.

Results 12 (of 47 cohort) not used suitable alternatives first, 31 not had Pregabalin reviewed within 12 months. All patients reviewed and 5 actively switched to Gabapentin (practice saved -£6275). Reaudit results at 1 year: 22 of cohort no longer on Pregabalin (19 stopped as neuropathic symptoms resolved or reported medication ineffective, 3 prescribed alternative medication). 25 patients remained on Pregabalin. Additional 11 new patients (not from original cohort) started on Pregabalin, of these 3 stopped after initial follow up review and 1 switched to alternative medication.

Conclusion BLM2 surgery saved over -£20 000 a year. Polypharmacy and inappropriate prescribing reduced (as patients taken off medication not required). Current and future patients on Pregabalin now easily identifiable for review as clinical flag on EMIS.

Key Message Many side effects associated with neuropathic pain treatment, thus importance of effective pain management using correct agents. Potential savings exist in primary care if correct prescribing guidelines and regular reassessment of patient’s pain and medication is adopted.