The Reduction of Mechanical Restraints and PRN Medication in 400 Persons with Neurodevelopmental Disorders: an Analysis of 11 Years Process in 23 Italian Residential Settings

PRN usage before and after discharge from a forensic inpatient unit: A series example of patients with intellectual disabilities

“…While the reason for this change may be multifactorial, the use of psychotropic medications to manage the challenging behaviour of individuals with intellectual and developmental disabilities remains controversial due to the potential for negative long‐term effects on health (Sullivan et al, 2018) and limited evidence of their short‐ or long‐term efficacy in treating challenging behaviour (Lunsky et al, 2018). Moreover, results of large‐scale analyses have indicated that behavioural interventions that effectively treat challenging behaviour coincide with reductions in restrictive interventions such as PRN medication, independent of clinical complexity (Leoni et al, 2018). This outcome suggests that behavioural treatment may be a more appropriate strategy to address challenging behaviour that occurs in both forensic inpatient and community settings, relative to PRN medication.…”

Organisational impact on the use of restrictive measures: The perspective of Swedish front‐line managers

“…A reduction in RM requires good (Stubbs et al, 2009) and values oriented (Leoni et al, 2018) leadership that supports staff in providing service according to legislation and organisational policies. To achieve this, managers need to know how service is delivered (Deveau & McGill, 2016).…”

“…However, a change in practice requires the involvement of management at all organisational levels (Bisschops et al, 2022; Martin et al, 2021; Olivier‐Pijpers et al, 2018) and practice leadership (Martin et al, 2021; McGill et al, 2020). Reducing the use of RM entails long‐term commitment in an organisation with a clear vision and structured framework (Leoni et al, 2018), and a focus on leadership factors that support change (Larue et al, 2018). It may require structural changes, for example, a reduction in the number of wards a manager had to oversee (Leoni et al, 2018).…”

Role of Naltrexone in Treatment of Refractory Self-Injurious Behavior in a Child With Intellectual Disability: A Case Report

“…1,2 SIB can lead to lacerations, tissue loss, and permanent scarring. 3,4 Various pharmacological agents have been studied to treat SIB, most of which have been antipsychotics. 5 Drug refractory SIB has been defined as SIBs requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of 3 psychotropic drugs, one of which was risperidone or aripiprazole.…”