Abstract：
The emerging issue of rising gabapentinoid misuse is being recognized 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 23 February 2022 without restrictions. Eligible studies included randomized, non-randomized 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 the type of intervention, prescribing rates, cessations, patient outcomes and adverse events. Extracted outcome data were categorized 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. Interventions were of dose-reducing protocols, education and/or pharmacological-based approaches. In the randomized 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-focused 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.
摘要：
随着目前缺乏支持安全有效的加巴喷丁类药物处方的证据，人们正在认识到加巴喷丁类药物滥用日益严重的问题。本范围审查旨在评估成人加巴喷丁类药物处方干预措施的程度和性质。无论是减少剂量，或开处方，加巴喷丁.电子数据库在2022年2月23日进行了搜索，没有任何限制。符合条件的研究包括随机，非随机和观察性研究，评估旨在减少/停止成人加巴喷丁类药物在临床上的任何适应症的处方/使用的干预措施。研究结果调查了干预类型，处方费率，割礼，患者结果,和不良事件。提取的结果数据被归类为短(≤3个月)，中期（>3但<12个月）或长期（≥12个月）。进行了叙事综合。纳入的四项研究是在初级和急性护理环境中进行的。干预是剂量减少方案，基于教育和/或药理学的方法。在随机试验中,至少三分之一的参与者可以停止使用gabapentinoid。在两项观察性试验中，加巴喷丁的处方率下降了9%。在一项试验中报告了严重不良事件和与加巴喷丁类药物特别相关的不良事件。没有研究包括在开处方过程中以患者为中心的心理干预，也没有提供任何长期随访。这篇综述强调了这方面缺乏现有证据。由于可用数据有限，我们的审查无法对成人最有效的加巴喷丁类药物处方干预措施做出任何坚定的判断，强调需要在这一领域进行更多的研究。
