Drug administration in day centres for people with learning disabilities

Abstract

A study was made of the problems associated with the need to administer medicines at day centres for people with learning disabilities. In Leicestershire, 167 (13%) of 1317 people with learning disabilities who attended day centres required the administration of medicines. The percentage of attenders requiring drug administration varied from day centre to day centre (minimum 4%, maximum 23%). Antiepileptics were the most commonly administered drugs, followed by antipsychotics. The administration of medicines took up a significant amount of time for senior members of the day centre staff and had a great potential for errors. In only 32 cases was it deemed essential that the drug administration occurred at the day centre.

Medication management in intellectual disability settings: A systematic review

“…However, several sources referred to it, while focusing on other parameters and variables. The information extracted from these sources largely clustered on themes of complexity (Branford et al, 1997; Burrow and Rimmer, 1997), risks (Hom et al, 2015; Rasaratnam et al, 2004; Tan et al, 2015; Van Den Bemt et al, 2007) and team makeup (Ellenor and Frisk, 1977; Van Den Bemt et al, 2007; Venables et al, 2015) with repeated emphasis on education and training (Abbott et al, 2014; Bosner and Belfiore, 2001; Buelow and Shore, 2010; Rasaratnam et al, 2004).…”

“…In a descriptive mixed-methods study, Branford et al (1997) identified the complexity of medication management, especially when it occurred across a number of locations (Burrow and Rimmer, 1997) as can be typical in intellectual disability settings. Describing the preparation, transport, storage, oversight and administration of this process, they highlighted the importance of collaboration and communication in minimising risk of medication errors.…”

“…These variances were seen between the records of GPs, consultants and home care services, again highlighting the risks associated with there being several parties to medication management. Although risks associated with disparate documentation (Burrow and Rimmer, 1997) and complexity of processes (Branford et al, 1997; Van Den Bemt et al, 2007) have been noted, the problems of non-adherence were also identified in the literature (Hom et al, 2015; Rasaratnam et al, 2004; Tan et al, 2015). Interestingly, Hom et al (2015) noted that, where there was adequate supervision, non-adherence rates reduced.…”

“…Interestingly, Hom et al (2015) noted that, where there was adequate supervision, non-adherence rates reduced. In all of these sources, though, the importance of good communication between professional themselves, between professionals and carers and between professionals and people with an intellectual disability was repeated (Branford et al, 1997; Burrow and Rimmer, 1997; Ellenor and Frisk, 1977; Venables et al, 2015).…”

“…Potential solutions included that the use of a transportable medication chart (Burrow and Rimmer, 1997) would travel with the person with an intellectual disability and increased interaction between professionals, carers and people with an intellectual disability, perhaps mediated through an enhanced role for pharmacists (Ellenor and Frisk, 1977; Van Den Bemt et al, 2007; Venables et al, 2015) both within service settings and between the various parties. This more visible role for the pharmacist within the medication management team was allied with an acceptance that this ‘team’ is much wider than just the healthcare professionals and includes family (Bosner and Belfiore, 2001; Branford et al, 1997; Buelow and Shore, 2010; Hom et al, 2015; Rasaratnam et al, 2004), direct support staff (social care) (Auberry et al, 2017; Rasaratnam et al, 2004) and people with an intellectual disability themselves (Bosner and Belfiore, 2001; Ellenor and Frisk, 1977; Hom et al, 2015). The importance of education and training on medication management, across the members of this team, was a common theme (Bosner and Belfiore, 2001; Buelow and Shore, 2010; Rasaratnam et al, 2004) with the pharmacist (Ellenor and Frisk, 1977; Van Den Bemt et al, 2007; Venables et al, 2015) and clinical nurse specialist (Buelow and Shore, 2010) singled out as having important educational and training roles.…”