Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours

Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.Design/methodology/approachThis study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.FindingsThis is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.Originality/valueThis is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advances in Mental Health and Intellectual Disabilities Emerald Publishing

Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours

Download PDF
10 pages

Loading next page...
 
/lp/emerald-publishing/antipsychotic-prescribing-for-patients-with-intellectual-disabilities-pCnkCBLRIy
Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
2044-1282
DOI
10.1108/amhid-11-2020-0030
Publisher site
See Article on Publisher Site

Abstract

Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.Design/methodology/approachThis study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.FindingsThis is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.Originality/valueThis is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.

Journal

Advances in Mental Health and Intellectual Disabilities – Emerald Publishing

Published: Jul 26, 2021

Keywords: NICE; Audit; Intellectual disability; Challenging behaviour; Antipsychotics; Polypharmacy

References

  • Prevalence and correlates of ‘high dose’ antipsychotic prescribing: findings from a hospital audit
    Adesola, A.; Anozie, I.; Erohubie, P.; James, B.
  • Psychotropic drug prescribing for people with intellectual disability, mental health problems and/or behaviours that challenge: practice guidelines
    Alexander, R.; Devapriam, J.; Branford, D; Roy, A.; Sheehan, R.; Anand, E.; Bhaumik, S.
  • Challenges and pitfalls of antipsychotic prescribing in people with learning disabilities
    Alexander, R.T.; Shankar, R.; Cooper, S.A.; Bhaumik, S.; Hastings, R.; Kapugama, C.L.; Roy, A.
  • Olanzapine vs. risperidone in treating aggressive behaviours in adults with intellectual disability: a single blind study
    Amore, M.; Bertelli, M.; Villani, D.; Tamborini, S.; Rossi, M.
  • Audit of antipsychotic prescribing in a private psychiatric hospital
    Botvinik, L.; Ng, C.; Schweitzer, I.
  • Prevalence of psychotropic medication use and association with challenging behaviour in adults with an intellectual disability. A total population study
    Bowring, D.L.; Totsika, V.; Hastings, R.P.; Toogood, S.; McMahon, M.
  • A review of antipsychotic drugs prescribed for people with learning disabilities who live in Leicestershire
    Branford, D.
  • Stopping over-medication of people with intellectual disability, autism or both (STOMP) in England part 1 – history and background of STOMP
    Branford, D.; Gerrard, D.; Saleem, N.; Shaw, C.; Webster, A.
  • Use of academic detailing with audit and feedback to improve antipsychotic pharmacotherapy
    Brunette, M.F.; Cotes, R.O.; de Nesnera, A.; McHugo, G.; Dzebisashvili, N.; Xie, H.; Bartels, S.J.
  • Appropriateness in health care: application to prescribing
    Buetow, S.A.; Sibbald, B.; Cantrill, J.A.; Halliwell, S.
  • The use of psychotropic medication with adults with learning disabilities: survey findings and implications for services
    Chapman, M.; Gledhill, P.; Jones, P.; Burton, M.; Soni, S.
  • Towards rational psychotropic prescribing for people with learning disability
    Clarke, D.J.
  • International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities
    Deb, S.; Kwok, H.; Bertelli, M.; Salvador-Carulla, L.; Bradley, E.; Torr, J.; Barnhill, J.
  • UK psychiatrists’ experience of withdrawal of antipsychotics prescribed for challenging behaviours in adults with intellectual disabilities and/or autism
    Deb, S.; Nancarrow, T.; Limbu, B.; Sheehan, R.; Wilcock, M.; Branford, D.; Shankar, R.
  • Use of PRN medication in people with intellectual disabilities
    Delafon, V.; Kiani, R.; Barrett, M.; Vahabzadeh, A.; Vaidya, H.; Walker, G.; Bhaumik, S.
  • The form and function of challenging behaviours
    Emerson, E.; Bromley, J.
  • Audit of anti psychotic medication usage in the community in a sample of people with learning disabilities
    Fernando, L.; Regan, A.; Khwaja, M.
  • Clinical outcomes of staff training in positive behaviour support to reduce challenging behaviour in adults with intellectual disability: cluster randomised controlled trial
    Hassiotis, A.; Poppe, M.; Strydom, A.; Vickerstaff, V.; Hall, I.S.; Crabtree, J.; Crawford, M.J.
  • Antipsychotics for BPSD: an audit of prescribing practice in a specialist psychiatric inpatient unit
    Haw, C.; Stubbs, J.; Yorston, G.
  • Polypharmacy in the treatment of subjects with intellectual disability
    Häβler, F.; Thome, J.; Reis, O.
  • The use of anti-psychotic drugs with adults with learning disabilities and challenging behaviour
    Kiernan, C.; Reeves, D.; Alborz, A.
  • Atypical antipsychotics for psychosis in adolescents
    Kumar, A.; Datta, S.S.; Wright, S.D.; Furtado, V.A.; Russell, P.S.
  • Effects of a comprehensive health assessment programme for australian adults with intellectual disability: a cluster randomized trial
    Lennox, N.; Bain, C.; Rey-Conde, T.; Purdie, D.; Bush, R.; Pandeya, N.
  • Dose equivalents for antipsychotic drugs: the DDD method
    Leucht, S.; Samara, M.; Heres, S.; Davis, J.M.
  • Prescribing patterns in a Hong Kong institution for adults with severe to profound learning disabilities
    Lim, W.
  • Mental health services for individuals with intellectual disabilities in Canada: findings from a national survey
    Lunsky, Y.; Garcin, N.; Morin, D.; Cobigo, V.; Bradley, E.
  • Antipsychotic prescribing for vulnerable populations: a clinical audit at an acute australian mental health unit at two-time points
    McMillan, S.S.; Jacobs, S.; Wilson, L.; Theodoros, T.; Robinson, G.; Anderson, C.; Wheeler, A.J.
  • Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service
    Marshall, T.
  • Challenging behaviour: a unified approach
    Morris, J.
  • Primary care use of antipsychotic drugs: an audit and intervention study
    Mortimer, A.M.; Shepherd, C.J.; Rymer, M.; Burrows, A.
  • Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research
    O’Dwyer, M.; McCallion, P.; McCarron, M.; Henman, M.
  • Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: a cross-sectional observational nationwide study
    O’Dwyer, M.; Peklar, J.; McCallion, P.; McCarron, M.; Henman, M.C.
  • Prevalence, patterns and factors associated with psychotropic use in older adults with intellectual disabilities in Ireland
    O’Dwyer, M.; Peklar, J.; Mulryan, N.; McCallion, P.; McCarron, M.; Henman, M.C.
  • Prescribing pattern of psychotropic medications in child psychiatric practice in a mental referral hospital in Botswana
    Olashore, A.; Ayugi, J.; Opondo, P.
  • Quality of prescribing for schizophrenia: evidence from a national audit in England and Wales
    Patel, M.X.; Bishara, D.; Jayakumar, S.; Zalewska, K.; Shiers, D.; Crawford, M.J.; Cooper, S.J.
  • Quality of prescribing of antipsychotic medication for people with intellectual disability under the care of UK mental health services: a cross-sectional audit of clinical practice
    Paton, C.; Bhatti, S.; Purandare, K.; Roy, A.; Barnes, T.
  • Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study
    Sheehan, R.; Hassiotis, A.; Walters, K.; Osborn, D.; Strydom, A.; Horsfall, L.
  • Epidemiology of mental health problems in adults with learning disability: an update
    Smiley, E.
  • Lessons learned from our elders: how to study polypharmacy in populations with intellectual and developmental disabilities
    Stortz, J.N.; Lake, J.K.; Cobigo, V.; Ouellette-Kuntz, H.M.; Lunsky, Y.
  • A multi-Centre audit of the use of medication for the management of behavioural problems in adults with intellectual disabilities
    Unwin, G.L.; Deb, S.
  • Impact of audit and feedback on antipsychotic prescribing in schizophrenia
    Wheeler, A.; Humberstone, V.; Robinson, E.; Sheridan, J.; Joyce, P.
  • Audit of antipsychotic prescribing in dementia: Cambridgeshire results and lessons learnt
    Wightman, R.; Fielding, J.; Green, S.
  • Chlorpromazine equivalents and percentage of British national formulary maximum recommended dose in patients receiving high-dose antipsychotics
    Yorston, G.; Pinney, A.