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Deprescribing interventions for gabapentinoids in adults: a scoping review
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  • Prue Anderson,
  • Andrew McLachlan,
  • Christina Abdel Shaheed,
  • Danijela Gnjidic,
  • Rowena Ivers,
  • Stephanie Mathieson
Prue Anderson
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Andrew McLachlan
The University of Sydney
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Christina Abdel Shaheed
The University of Sydney Institute for Musculoskeletal Health
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Danijela Gnjidic
The University of Sydney School of Pharmacy
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Rowena Ivers
University of Wollongong Faculty of Science Medicine and Health
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Stephanie Mathieson
The University of Sydney Institute for Musculoskeletal Health

Corresponding Author:[email protected]

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Abstract

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.
12 Dec 2022Submitted to British Journal of Clinical Pharmacology
15 Dec 2022Submission Checks Completed
15 Dec 2022Assigned to Editor
15 Dec 2022Review(s) Completed, Editorial Evaluation Pending
18 Dec 2022Reviewer(s) Assigned
26 Jan 2023Editorial Decision: Revise Major
08 Mar 20231st Revision Received
09 Mar 2023Submission Checks Completed
09 Mar 2023Assigned to Editor
09 Mar 2023Review(s) Completed, Editorial Evaluation Pending
12 Mar 2023Reviewer(s) Assigned
03 May 2023Editorial Decision: Accept