scholarly journals Prevalence of psychotropic medication use and association with challenging behaviour in adults with an intellectual disability. A total population study

2017 ◽  
Vol 61 (6) ◽  
pp. 604-617 ◽  
Author(s):  
D. L. Bowring ◽  
V. Totsika ◽  
R. P. Hastings ◽  
S. Toogood ◽  
M. McMahon
Keyword(s):  
Intellectual Disability ◽  
Population Study ◽  
Psychotropic Medication ◽  
Total Population ◽  
Medication Use ◽  
Challenging Behaviour

scholarly journals Experiences of psychotropic medication use and decision-making for adults with intellectual disability: a multistakeholder qualitative study in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032861 ◽  
Author(s):  
Rory Sheehan ◽  
Angela Hassiotis ◽  
André Strydom ◽  
Nicola Morant
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Stakeholder Involvement ◽  
Medication Use ◽  
Care Providers ◽  
Family Carers ◽  
Joint Decisions ◽  
The Uk ◽  
Medication Decisions

ObjectivesUnderstanding patient and carer perspectives is essential to improving the quality of medication prescribing. This study aimed to explore experiences of psychotropic medication use among people with intellectual disability (ID) and their carers, with a focus on how medication decisions are made.DesignThematic analysis of data collected in individual semistructured interviews.Participants and settingFourteen adults with ID, 12 family carers and 12 paid carers were recruited from specialist psychiatry services, community groups, care providers and training organisations in the UK.ResultsPeople with ID reported being highly compliant with psychotropic medication, based on a largely unquestioned view of medication as important and necessary, and belief in the authority of the psychiatrist. Though they sometimes experienced medication negatively, they were generally not aware of their right to be involved in medication decisions. Paid and family carers reported undertaking a number of medication-related activities. Their ‘front-line’ status and longevity of relationships meant that carers felt they possessed important forms of knowledge relevant to medication decisions. Both groups of carers valued decision-making in which they felt they had a voice and a genuine role. While some in each group described making joint decisions about medication with psychiatrists, lack of involvement was often described. This took three forms in participants’ accounts: being uninformed of important facts, insufficiently included in discussions and lacking influence to shape decisions. Participants described efforts to democratise the decision-making process by gathering information, acting to disrupt perceived power asymmetries and attempting to prove their credibility as valid decision-making partners.ConclusionsStakeholder involvement is a key element of medication optimisation that is not always experienced in decisions about psychotropic medication for people with ID. Forms of shared decision-making could be developed to promote collaboration and offer people with ID and their carers greater involvement in medication decisions.

scholarly journals Psychotropic medication use in adolescents with intellectual disability living in the community

2013 ◽  
Vol 23 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Tan Doan ◽  
Robert Ware ◽  
Lyn McPherson ◽  
Kate van Dooren ◽  
Christopher Bain ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Medication Use

Foster Carers Who Care for Children with Challenging Behaviour: A Total Population Study

2004 ◽  
Vol 28 (3) ◽  
pp. 20-30 ◽  
Author(s):  
Andrew Pithouse ◽  
Kathy Lowe ◽  
Jan Hill-Tout
Keyword(s):  
Population Study ◽  
Total Population ◽  
Challenging Behaviour

scholarly journals Appropriateness of psychotropic medication use in a cohort of adolescents with intellectual disability in Queensland, Australia

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Menghuan Song ◽  
Robert S. Ware ◽  
Tan N. Doan ◽  
Lyn McPherson ◽  
Julian N. Trollor ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Clinical Decision Making ◽  
Medical Condition ◽  
Inappropriate Prescribing ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Off Label ◽  
Inappropriate Use ◽  
Challenging Behaviours

Background Psychotropic medications are sometimes used off-label and inappropriately. This may cause harm to adolescents with intellectual disability. However, few studies have analysed off-label or inappropriate prescribing to this group. Aims To examine the appropriateness of psychotropic prescribing to adolescents with intellectual disability living in the community in south-east Queensland, Australia. Method Off-label medication use was determined based on whether the recorded medical condition treated was approved by the Australian Therapeutic Goods Administration. Clinical appropriateness of medication use was determined based on published guidelines and clinical opinion of two authors who specialise in developmental disability medicine (J.N.T. and D.H.). Results We followed 429 adolescents for a median of 4.2 years. A total of 107 participants (24.9%) were prescribed psychotropic medications on at least one occasion. Of these, 88 (82.2%) were prescribed their medication off-label or inappropriately at least once. Off-label or inappropriate use were most commonly associated with challenging behaviours. Conclusions Off-label or inappropriate use of psychotropic medications was common, especially for the management of challenging behaviours. Clinical decision-making accounts for individual patient factors and is made based on clinical experience as well as scientific evidence, whereas label indications are developed for regulatory purposes and, although appropriate at a population level, cannot encompass the foregoing considerations. Education for clinicians and other staff caring for people with intellectual disability, and a patient-centred approach to prescribing with involvement of families should encourage appropriate prescribing. The effect of the National Disability Insurance Scheme on the appropriateness of psychotropic medication prescribing should be investigated.

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