Obara, IlonaAlotaibi, Jawza2023-12-212023-12-212023-12-21https://hdl.handle.net/20.500.14154/70328Three publications have resulted from this thesis.In 2019, gabapentinoids were reclassified as a controlled substance in the United Kingdom to tackle their misuse. The focus of this thesis was to assess the safety of gabapentinoids in the management of neuropathic pain for adults and to clarify community pharmacists’ (CPs) role in tackling gabapentinoid misuse. Firstly, a systematic review and meta-analysis were conducted to investigate the safety of gabapentinoids. Fifty studies were included. Most adverse events (AEs) pertained to the nervous system or psychiatric disorders. Pregabalin had more AEs than gabapentin. There was no evidence of addiction to gabapentinoids found. Euphoria was the adverse event of pregabalin that may correlate with addiction. Literature suggests that gabapentinoids are commonly misused concurrently with opioid use. An in-vivo study was conducted to investigate pregabalin reinforcing efficacy after exposure to morphine self-administration. Twelve naïve rats went through three phases: acquisition, extinction, and reinstatement. A significant difference was observed between the number of active levers in the reinstatement compared to the extinction phase. Results showed that pregabalin might have a reinforcing efficacy. A second systematic review was conducted to investigate CPs‐led interventions in analgesia misuse. Six studies were included. The identified interventions were mapped to Behaviour Change Wheel. Then, a qualitative study was conducted to explore CPs’ perspectives about addressing inappropriately prescribed analgesia (IPA). Semi-structured interviews were conducted with 12 CPs. Nine Theoretical Domains Framework were identified. Seventeen behaviour change techniques were identified that could be considered in designing future interventions. Overall, the thesis findings provide a comprehensive safety profile of gabapentinoids in neuropathic pain. There was no evidence of gabapentinoid use causing addiction. Further investigations are required to confirm pregabalin reinforcing properties when substituted for morphine. There is limited evidence of CPs‐led interventions to tackle IPA, this thesis provides an in-depth explanation of the determinants to address IPA from CPs’ perspectives.365enPatient CareAnalgesiaPainThesis