Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service

Abstract

Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service AIMS AND METHODThe aims of the study were to identify patients in a community learning disability service receiving psychotropic medication for challenging behaviour, to examine prescribing practice and to compare this against local consensus standards. Local consensus standards were agreed by the consultants and the notes were reviewed by the author. RESULTSA total of102 patients were identified as receiving psychotropic

Lessons Learned From Our Elders: How to Study Polypharmacy in Populations With Intellectual and Developmental Disabilities

“…Antipsychotic and antidepressant medications are among the most frequently prescribed psychotropic medication classes in populations with IDD (Aman et al, 2003;Burd et al, 1997;Esbensen et al, 2009;Hurley et al, 2003;Lott et al, 2004;Lunsky & Elserafi, 2012;Martin, Scahill, Klin, & Volkmar, 1999;Marshall, 2004;Molyneux et al, 1999;Robertson et al, 2000;Spreat et al, 2004), yet guidelines specific to the care of these individuals do not advise beyond general psychotropic medication considerations. It is clear that population-specific, explicit guidelines for prescribing medications are necessary to aid in assessing and improving the quality of care received by this population.…”

“…Polypharmacy rates among individuals with IDD range considerably with some studies reporting rates as low as 11% and others as high as 60%, depending on the study methods (Bisconer et al, 1996;Burd et al, 1997;Lake, Balogh, & Lunsky, 2012;Lott et al, 2004;Lunsky & Elserafi, 2012;Marshall, 2004;McGillivray & McCabe, 2006;Stolker, Heerdink, Leufkens, Clerkx, & Nolen, 2001;Wood et al, 2006). Variability in polypharmacy rates highlights the need for careful consideration of how rates are derived, particularly if they are to be used as an indicator of quality of health care.…”

“…In particular, the prescribing of psychotropic medication is common among individuals with IDD with rates of psychotropic medication usage estimated between 28% and 89% (Bisconer, Sine, & Zhang, 1996;Burd et al, 1997;Lott et al, 2004;Molyneux, Emerson, & Caine, 1999;National Core Indicators, 2012;Spreat, Conroy, & Fullerton, 2004). Antipsychotic drugs are the most commonly prescribed psychotropic medications among individuals with IDD (Aman, Lam, & Collier-Crespin, 2003;Aman, Lam, & Van Bourgondien, 2005;Esbensen, Greenberg, Seltzer, & Aman, 2009;Hurley, Folstein, & Lam, 2003;Marshall, 2004;Molyneux et al, 1999;National Core Indicators, 2012;Robertson et al, 2000;Spreat et al, 2004). In addition to high rates of medication use, individuals with IDD often have difficulty reporting and understanding side effects (Aman, Benson, Campbell, & Haas, 1999;Bradley, 2002;Gardner Wilson, Lott, & Tsai, 1998;Lunsky et al, 2008;Zametkin & Yamada, 1993), they are at heightened risk of paradoxical side effects (Gardner Wilson et al, 1998), and they may not have the capacity to consent to medication use (Aman et al, 1999;Lunsky et al, 2008).…”

Use of antipsychotic drugs in individuals with intellectual disability (ID) in the Netherlands: prevalence and reasons for prescription

“…Apparently, the use of antipsychotics is on the rise, despite the publication of a specialist guideline for the prescription of psychotropic agents in persons with IDs in the Netherlands. Lack of commitment to guidelines has been reported for other countries too (Holden & Gitlesen 2004; Marshall 2007). However, because the NVAVG guideline was published only 8 months before the reference date of this study, treatment policies of Dutch ID physicians may not have completely changed yet.…”

Factors Influencing the Use of Psychotropic Medication for Challenging Behaviour in the United Kingdom: A Q Method Investigation

“…evaluation of interventions from baseline). Furthermore, the finding that side‐effects are not perceived as informing the decision‐making process might help to explain why individuals with learning disabilities are rarely informed of possible side‐effects (Crossley & Withers ) and raises concerns about the long‐term use of psychotropic medication in the absence of appropriate monitoring (Marshall ).…”