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Objective: This paper aims to understand spatial and temporal trends in pregabalin prescribing and the relationship with deprivation across England at both general practice and clinical commissioning group (CCG) levels., Design: A set of 207 independent generalised additive models are employed to model the spatiotemporal trend of pregabalin prescribed and dispensed per 1000 population, adjusting for deprivation. The response variable is pregabalin prescribed in milligrams, with weighted Index of Multiple Deprivation (IMD), geographical location and time as predictors. The set of active prescribing facilities grouped within CCG is the unit of analysis., Setting: National Health Service open prescribing data; all general practices in England, UK between January 2015 and June 2017., Population: All patients registered to general practices in England, UK., Results: Adjusting for deprivation, a North-South divide is shown in terms of prescribing trends, with the North of England showing increasing prescribing rates during the study period on average, while in the South of England rates are on average decreasing. Approximately 60% of general practices showed increasing prescribing rate, with the highest being 4.03 (1.75 for the most decreasing). There were no apparent spatial patterns in baseline prescription rates at the CCG level. Weighted IMD score proved to be statistically significant in 138 of 207 CCGs. Two-thirds of CCGs showed more pregabalin prescribed in areas of greater deprivation. Whether the prescribing rate is high due to high baseline prescription rate or increasing rates needs to be specifically looked at., Conclusions: The spatial temporal modelling demonstrated that the North of England has a significantly higher chance to see increase in pregablin prescriptions compared with the South, adjusted for weighted IMD. Weighted IMD has shown positive impact on pregabalin prescriptions for 138 CCGs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Resistance to currently available anthelmintics is a serious phenomenon which is prevalent globally. Cyathostomins are one of the major parasites, and are of primary concern in donkeys. There have been reports of emerging resistance to pyrantel, but the status of pyrantel resistance in donkey populations in the UK is largely unknown. This report investigates pyrantel resistance in two geographically isolated donkey herds in the South West of England. The first herd had suspected pyrantel resistance, with already established resistance to other anthelmintics. In the second herd the efficacy of pyrantel was not suspected at the time the study took place. Faecal Egg Count Reduction Test (FECRT) was carried out, revealing large scale resistance. Eighty one percent of the first herd and 73% of the second herd had a FEC of less than 95% after treatment, and anthelmintic resistance was confirmed using the World Association for the Advancement of Veterinary Parasitology guidelines. These findings indicate that anthelmintic resistance to pyrantel exists in both tested donkey populations and illustrate the continuing development of resistance through different classes of chemotherapeutics., (Copyright © 2014 Elsevier B.V. All rights reserved.)