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dc.contributor.authorShaw, L
dc.contributor.authorNunns, M
dc.contributor.authorBriscoe, S
dc.contributor.authorGarside, R
dc.contributor.authorTurner, M
dc.contributor.authorMelendez-Torres, GJ
dc.contributor.authorLawal, HM
dc.contributor.authorCoon, JT
dc.date.accessioned2023-06-14T12:27:10Z
dc.date.issued2023-05-29
dc.date.updated2023-06-14T12:03:21Z
dc.description.abstractOBJECTIVES: We 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. METHODS: Eight 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. RESULTS: We 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. CONCLUSIONS: The 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.en_GB
dc.description.sponsorshipNational Institute for Health Research (NIHR)en_GB
dc.format.extent13558196231164592-
dc.format.mediumPrint-Electronic
dc.identifier.citationPublished online 29 May 2023en_GB
dc.identifier.doihttps://doi.org/10.1177/13558196231164592
dc.identifier.grantnumberNIHR200695en_GB
dc.identifier.urihttp://hdl.handle.net/10871/133384
dc.identifierORCID: 0000-0002-6092-5019 (Shaw, Liz)
dc.identifierORCID: 0000-0002-5161-0234 (Coon, Jo Thompson)
dc.language.isoenen_GB
dc.publisherSAGE Publicationsen_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/37247513en_GB
dc.rights© The Author(s) 2023. Creative Commons License (CC BY 4.0) This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).en_GB
dc.subjectadulten_GB
dc.subjectdrug-dependencyen_GB
dc.subjectmapping reviewen_GB
dc.titleOptimising the prescribing of drugs that may cause dependency: An evidence and gap map of systematic reviews.en_GB
dc.typeArticleen_GB
dc.date.available2023-06-14T12:27:10Z
dc.identifier.issn1355-8196
exeter.place-of-publicationEngland
dc.descriptionThis is the final version. Available from SAGE Publications via the DOI in this record. en_GB
dc.identifier.eissn1758-1060
dc.identifier.journalJournal of Health Services Research & Policyen_GB
dc.relation.ispartofJ Health Serv Res Policy
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_GB
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2023-05-29
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2023-06-14T12:23:49Z
refterms.versionFCDVoR
refterms.dateFOA2023-06-14T12:27:14Z
refterms.panelAen_GB
refterms.dateFirstOnline2023-05-29


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© The Author(s) 2023. 
Creative Commons License (CC BY 4.0)
This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Except where otherwise noted, this item's licence is described as © The Author(s) 2023. Creative Commons License (CC BY 4.0) This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).