The emerging issue of rising gabapentinoid misuse is being recognised
alongside the lack of current evidence supporting the safe and effective
deprescribing of gabapentinoids. This scoping review aimed to assess the
extent and nature of gabapentinoid deprescribing interventions in
adults, either in reducing dosages, or prescribing of, gabapentinoids.
Electronic databases were searched on 23rd February 2022 without
restrictions. Eligible studies included randomised, non-randomised and
observational studies that assessed an intervention aimed at
reducing/ceasing the prescription/use of a gabapentinoid in adults for
any indication in a clinical setting. The research outcomes investigated
type of intervention, prescribing rates, cessations, patient outcomes,
and adverse events. Extracted outcome data was categorised as either
short (≤ 3 months), intermediate (>3 but <12
months) or long (≥ 12 months) term. A narrative synthesis was conducted.
The four included studies were conducted in primary and acute care
settings. Intervention were of dose reducing protocols, education and/or
pharmacological-based approaches. In the randomised trials,
gabapentinoid use could be ceased in at least one-third of participants.
In the two observational trials, gabapentinoid prescribing rates
decreased by 9%. Serious adverse events and adverse events specifically
related to gabapentinoids were reported in one trial. No study included
patient-focussed psychological interventions in the deprescribing
process, nor provided any long-term follow-up. This review highlights
the lack of existing evidence in this area. Due to limited available
data, our review was unable to make any firm judgements on the most
effective gabapentinoid deprescribing interventions in adults,
highlighting the need for more research in this area.