In question

‘Can I deprescribe gabapentin and pregabalin now that they have been reclassified to controlled drug status?’

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Pip White CSP's professional adviser

No. In Great Britain from 1 April 2019 you can no longer write prescriptions for these medicines. 

This includes deprescribing the medicines as part of reducing a patient’s use of them. 

Deprescribing involves creating a new prescription for a lower dose. Items prescribed before 1 April, but not collected by the patient by this date, cannot be issued to the patient by a pharmacist. 

If practicable, you must switch to supplementary prescribing. 

You can continue to prescribe these medicines under a clinical management plan written with a doctor before prescribing occurs. 

You can prescribe and deprescribe for a maximum of 30 days’ supply for each prescription, with each prescription valid for 28 days only. 

You cannot issue repeatable prescriptions. Where supplementary prescribing is not possible, you must tell the patient to make an appointment with an alternative prescriber, usually a doctor, to review their prescriptions. 

The CSP, and NHS England, are aware of the impact this has on patients, services and delivery of key initiatives. These include first contact practitioners and the NHS England Long Term Plan, published earlier this year.

The CSP has already successfully made the case for the inclusion of gabapentin and pregablin in any future public consultation on updating  the list of seven controlled drugs that are currently available to physiotherapist independent prescribers. 

We do not need any further information on why these medicines are needed in physiotherapy practice. 

However, what we do need is data about the impact of this reclassification to back up our presented case of need. 

Please collect data on how many patients per week you now divert to a doctor for a prescription. In addition, please collect data about how many times you interrupt a doctor to write a prescription for you. 

We are working with key members to collect this data and will publish more details on our website on how to submit your data, once it is finalised. 

 

 

  • Author:  Pip White is a CSP professional adviser

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