TY - JOUR
T1 - Deprescribing paracetamol in pain conditions
T2 - A scoping review
AU - Patterson, Thomas Gabriel
AU - Beckenkamp, Paula
AU - Ferreira, Manuela
AU - Turner, Justin
AU - Gnjidic, Danijela
AU - Chen, Yanyu
AU - Mesa Castrillion, Carlos Ivan
AU - Ferreira, Paulo
N1 - Funding Information:
The conducted research was preregistered with an analysis plan in an independent, institutional registry. This involved registering; the study design, variables, and treatment conditions and specification of the sequence of analyses that are reported.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/8
Y1 - 2022/8
N2 - Objective: To examine evidence on deprescribing paracetamol in pain conditions and inform future strategies for paracetamol deprescription. Design: Scoping review. Participants: Adults with pain conditions, taking paracetamol. Results: After two independent teams of reviewers screening for titles, abstracts, and then full texts, 16 original articles were included. Deprescribing strategies were grouped into 5 categories: (1) Pharmacological, (2) Psychological, (3) Physiological, (4) Policy, and (5) Combination. We found strategies were predominately consumer-focused, conducted in community settings and involved individuals experiencing musculoskeletal pain (such as low back pain and osteoarthritis). A total of twelve studies investigated interventions targeting dose reduction and four studies examined interventions focusing on discontinuation of paracetamol. The most common strategies used to deprescribe paracetamol in pain conditions were physiological strategies, followed by psychological strategies. All included studies demonstrated some level of effectiveness to deprescribe paracetamol in a pain conditions through dose reduction or discontinuation, although the effectiveness of deprescribing strategies were highly variable, ranging from the majority of participants discontinuing their paracetamol use, to less than 10% reducing their paracetamol use upon the latest follow-up. Conclusions: There are clear opportunities for prospective trials to be designed more purposely and primarily focused to influence reduction and cessation of paracetamol for specific pain conditions where deprescription is appropriate.
AB - Objective: To examine evidence on deprescribing paracetamol in pain conditions and inform future strategies for paracetamol deprescription. Design: Scoping review. Participants: Adults with pain conditions, taking paracetamol. Results: After two independent teams of reviewers screening for titles, abstracts, and then full texts, 16 original articles were included. Deprescribing strategies were grouped into 5 categories: (1) Pharmacological, (2) Psychological, (3) Physiological, (4) Policy, and (5) Combination. We found strategies were predominately consumer-focused, conducted in community settings and involved individuals experiencing musculoskeletal pain (such as low back pain and osteoarthritis). A total of twelve studies investigated interventions targeting dose reduction and four studies examined interventions focusing on discontinuation of paracetamol. The most common strategies used to deprescribe paracetamol in pain conditions were physiological strategies, followed by psychological strategies. All included studies demonstrated some level of effectiveness to deprescribe paracetamol in a pain conditions through dose reduction or discontinuation, although the effectiveness of deprescribing strategies were highly variable, ranging from the majority of participants discontinuing their paracetamol use, to less than 10% reducing their paracetamol use upon the latest follow-up. Conclusions: There are clear opportunities for prospective trials to be designed more purposely and primarily focused to influence reduction and cessation of paracetamol for specific pain conditions where deprescription is appropriate.
KW - Deprescribing
KW - Medication
KW - Pain
KW - Paracetamol
KW - Scoping review
UR - http://www.scopus.com/inward/record.url?scp=85121099368&partnerID=8YFLogxK
U2 - 10.1016/j.sapharm.2021.11.008
DO - 10.1016/j.sapharm.2021.11.008
M3 - Article
AN - SCOPUS:85121099368
SN - 1551-7411
VL - 18
SP - 3272
EP - 3283
JO - Research in Social and Administrative Pharmacy
JF - Research in Social and Administrative Pharmacy
IS - 8
ER -