Evidence map›Paper›PMID 37247513›Full record

ReviewJournal of health services research & policy2023

Optimising the prescribing of drugs that may cause dependency: An evidence and gap map of systematic reviews.

Liz Shaw, Michael Nunns, Simon Briscoe, Ruth Garside, Malcolm Turner, G J Melendez-Torres, Hassanat M Lawal, Jo Thompson Coon

Abstract readReview
In one paragraph

Review in Journal of health services research & policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Liz ShawResearch Fellow, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.ORCID 0000-0002-6092-5019
Michael NunnsResearch Fellow, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.
Simon BriscoeInformation Specialist, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.
Ruth GarsideAssociate Professor in Evidence Synthesis, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility and Faculty of Health and Life Sciences, European Centre for Environment and Health, University of Exeter, UK.
Malcolm TurnerPatient and Public Representative, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.
G J Melendez-TorresProfessor in Clinical and Social Epidemiology, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.
Hassanat M LawalGraduate Research Associate, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.
Jo Thompson CoonProfessor of Evidence Synthesis and Health Policy - National Institute for Health and Care Research Applied Research Collaborations, Faculty of Health and Life Sciences, Exeter Policy Research Programme Evidence Review Facility, University of Exeter, UK.

Funding

Department of Health NIHR200695
6 · The paper itself

Abstract

objectivesWe set out to map the quantitative and qualitative systematic review evidence available to inform the optimal prescribing of drugs that can cause dependency (benzodiazepines, opioids, non-benzodiazepine hypnotics, gabapentinoids and antidepressants). We also consider how this evidence can be used to inform decision-making in the patient care pathway for each type of medication.

methodsEight bibliographic databases were searched for the period 2010 to 2020. All included reviews were initially appraised using four items from the Collaboration for Environmental Evidence Synthesis Assessment Tool, with reviews that scored well on all items proceeding to full quality appraisal. Key characteristics of the reviews were tabulated, and each review was incorporated into an evidence and gap map based on a patient care pathway. The care pathway was based upon an amalgamation of existing NICE guidelines and feedback from clinical and patient stakeholders.

resultsWe identified 80 relevant reviews and displayed them in an evidence and gap map. The evidence included in these reviews was predominantly of low overall quality. Areas where systematic reviews have been conducted include barriers and facilitators to the deprescribing of drugs that may cause dependency, although we identified little evidence exploring the experiences or evaluations of specific interventions to promote deprescribing. All medications of interest, apart from gabapentinoids, were included in at least one review.

conclusionsThe evidence and gap map provides an interactive resource to support (i) policy developers and service commissioners to use evidence in the development and delivery of services for people receiving a prescription of drugs that may cause dependency, where withdrawal of medication may be appropriate, (ii) the clinical decision-making of prescribers and (iii) the commissioning of further research. The map can also be used to inform the commissioning of further systematic reviews. To address the concerns regarding the quality of the existing evidence based raised in this report, future reviews should be conducted according to best-practice guidelines. Systematic reviews focusing on evaluating interventions to promote deprescribing would be particularly beneficial, as would reviews focusing on addressing the paucity of evidence regarding the deprescription of gabapentinoids.

Indexed as

Clinical Decision-MakingPolicyHumansPharmaceutical PreparationsSystematic Reviews as TopicPharmaceutical Preparationsadultdrug-dependencymapping review

Identifiers

PMID37247513
PMCPMC10515472

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.