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Adherence of clinicians to guidelines for the prescription of antipsychotic drugs to people with intellectual disabilities

Adherence of clinicians to guidelines for the prescription of antipsychotic drugs to people with... PurposeAntipsychotic drugs are frequently prescribed to people with intellectual disabilities (ID) to ameliorate psychotic symptoms and behavioural symptoms with and without mental condition. Guidelines recommend systematic evaluation of treatment effects and adverse effects, and limiting the treatment duration. Studies have shown that adherence to prescription guidelines is beneficial for clients’ outcomes. Therefore, the purpose of this paper is to investigate the adherence to antipsychotic drug prescription guidelines in two treatment settings.Design/methodology/approachA checklist, based on existing antipsychotic drug prescription guidelines, was used to evaluate the adherence of prescribers to guidelines in two settings in the Netherlands, i.e., in specialized intellectual disability (ID) care organizations and mental health care organizations. Data from medical records of clients who used antipsychotic drugs (n=299) were compared to the items of the checklist.FindingsTreatment effects were measured with validated scales in both settings in only 2.7 per cent of cases. Prescriptions were for problem behaviour in the absence of a psychotic disorder or psychotic symptoms in 90 per cent (specialized ID care) and in 79 per cent (mental health care) of cases. In specialized ID care pipamperone (31.9 per cent) and in mental health care risperidone (48.5 per cent) was most often prescribed. Adverse effects were monitored more frequently in specialized ID care.Originality/valueThe adherence to guidelines for prescribing antipsychotic drug to people with ID is insufficient in the Netherlands, because of shortcomings in the evaluation of treatment and adverse effects. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advances in Mental Health and Intellectual Disabilities Emerald Publishing

Adherence of clinicians to guidelines for the prescription of antipsychotic drugs to people with intellectual disabilities

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
2044-1282
DOI
10.1108/AMHID-02-2017-0005
Publisher site
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Abstract

PurposeAntipsychotic drugs are frequently prescribed to people with intellectual disabilities (ID) to ameliorate psychotic symptoms and behavioural symptoms with and without mental condition. Guidelines recommend systematic evaluation of treatment effects and adverse effects, and limiting the treatment duration. Studies have shown that adherence to prescription guidelines is beneficial for clients’ outcomes. Therefore, the purpose of this paper is to investigate the adherence to antipsychotic drug prescription guidelines in two treatment settings.Design/methodology/approachA checklist, based on existing antipsychotic drug prescription guidelines, was used to evaluate the adherence of prescribers to guidelines in two settings in the Netherlands, i.e., in specialized intellectual disability (ID) care organizations and mental health care organizations. Data from medical records of clients who used antipsychotic drugs (n=299) were compared to the items of the checklist.FindingsTreatment effects were measured with validated scales in both settings in only 2.7 per cent of cases. Prescriptions were for problem behaviour in the absence of a psychotic disorder or psychotic symptoms in 90 per cent (specialized ID care) and in 79 per cent (mental health care) of cases. In specialized ID care pipamperone (31.9 per cent) and in mental health care risperidone (48.5 per cent) was most often prescribed. Adverse effects were monitored more frequently in specialized ID care.Originality/valueThe adherence to guidelines for prescribing antipsychotic drug to people with ID is insufficient in the Netherlands, because of shortcomings in the evaluation of treatment and adverse effects.

Journal

Advances in Mental Health and Intellectual Disabilities – Emerald Publishing

Published: May 2, 2017

References

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  • Effects of controlled discontinuation of long‐term used antipsychotics for behavioural symptoms in individuals with intellectual disability
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  • International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities