Stakeholder experiences of deprescribing psychotropic medicines for challenging behaviour in people with intellectual disabilities

IF 0.5 Q4 EDUCATION, SPECIAL Tizard Learning Disability Review Pub Date : 2024-01-30 DOI:10.1108/tldr-09-2023-0020
Danielle Adams, Richard P. Hastings, Ian Maidment, Chetan Shah, Peter E. Langdon
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Abstract

Purpose

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

Design/methodology/approach

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Findings

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

Originality/value

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

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利益相关者对智障人士因挑战行为而停用精神药物的经验
目的有证据表明,为管理智障人士的挑战性行为而开具的精神药物处方过多,这促使英国在全国范围内开展了促进去处方化的计划,例如停止为(有学习障碍、自闭症或两者兼有的)人士开具过多的药物处方。为了成功实施取消处方的举措,我们需要了解如何让利益相关者参与到这一过程中来。设计/方法学/方法学在一项已发表的系统性综述中,我们报告了有关对有智力障碍和挑战行为的各年龄段患者取消精神药物处方的过程的证据。作为原始综述的一部分,我们搜索了有关利益相关者在精神药物停药过程中的经历的证据,并在本研究中对其进行了综合和报告。让照护者和智障人士参与进来、提供持续的支持并改善非药物干预(包括积极行为支持)的获取途径,可能有助于取得成功结果,包括减少或停用精神药物以及改善生活质量。实施精神药物停药需要采用多学科协作护理方法,并对利益相关者进行教育。原创性/价值以前没有对利益相关者在为有智力障碍和挑战行为的人停用精神药物方面的经验进行过回顾。现有文献很少,需要进一步研究。
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来源期刊
Tizard Learning Disability Review
Tizard Learning Disability Review EDUCATION, SPECIAL-
CiteScore
1.50
自引率
16.70%
发文量
20
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