4.1 Summary of findings
This review consolidated the current evidence surrounding gabapentinoid
deprescribing interventions, and found only two eligible randomised
trials, two observational studies and three ongoing clinical trials. At
present, from the small number of studies gabapentinoid deprescribing
can be successfully achieved (e.g. gabapentinoid use ceased in at least
one third of participants in randomised trials (31, 32) and
gabapentinoid prescribing rates reduced by 9% in observational studies)
(27, 28). However careful consideration and management of the adverse
effects, including withdrawal, is required. Deprescribing interventions
that targeted clinicians were education-based, directed at improving
clinician knowledge, confidence, clinical behaviour and patterns of
prescribing and included the provision of individualised deprescribing
reports. (31) Patient-focused interventions were similarly
education-based, with the study by McDonald et al targeting older
patient populations with the intention of improving patient’s awareness
of deprescribing. (28) Only one study investigated an intervention that
involved a tapering/ceasing protocol (32), however it is unclear the
extent of influence the ‘rescue taper’ may have had on the study’s
results. There was a lack of long-term data and no study looked at the
potential need or benefit of psychological support during the
deprescribing process, despite qualitative research suggesting
psychological support to be an essential part of effective
deprescribing. (34)