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)