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.