4.3 Strengths and weaknesses
This review is the first review to explore the landscape surrounding the effectiveness of previous gabapentinoid deprescribing interventions and our robust search strategy did not have any language or publication date restrictions. We also included all indications for gabapentinoid use (including off-label) and included studies that reported gabapentinoid specific deprescribing data as either primary or secondary outcomes. Both randomised trials included were of a large sample size, however, only one trial was specific to focussing on gabapentinoid deprescribing. (32) Whilst the other trial had gabapentinoid-specific outcome data, its primary objective was to deprescribe any potentially inappropriate medications that contributed to polypharmacy. (31) Due to being an emerging research area, our original screening for the systematic review found no eligible studies for inclusion, and hence resulted the review being converted into a scoping review. Whilst the two recently published observational studies were abstracts only, (27, 28) correspondence with authors suggests these studies will be published in the near future and will add to the growing body of evidence in this area alongside three registered, ongoing trials. Due to the wide variation in types of interventions and the small pool of studies, we were unable to draw direct comparisons between the studies, but presenting the results and risk of bias assessments per randomised-controlled trials and observational studies can guide readers to make their own conclusions on the current body of evidence. Finally, the data collected from included studies was not specific to particular conditions (e.g. data from the McDonald et al study represented gabapentinoids perceived to be potentially inappropriate medications) and therefore cannot be generalisable to individual pain groups.