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The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities

Isabel C.H. Clare (NIHR CLAHRC East of England, Cambridge, UK) (Department of Psychiatry, University of Cambridge, Cambridge, UK)
Kelly A. Wade (Department of Psychiatry, University of Cambridge, and NIHR CLAHRC East of England at Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK)
Sorcha Bolton (Department of Psychiatry, University of Cambridge, and NIHR CLAHRC East of England at Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK)
Adam P. Wagner (NIHR CLAHRC East of England, Cambridge, UK) (Norwich Medical School, University of East Anglia, Norwich, UK)
Tatsiana Steven (Department of Psychiatry, University of Cambridge, and NIHR CLAHRC East of England at Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK)
Anthony J. Holland (Department of Psychiatry, University of Cambridge, Cambridge, UK)

Tizard Learning Disability Review

ISSN: 1359-5474

Article publication date: 2 January 2018

585

Abstract

Purpose

The purpose of this paper is to examine the extent to which, in the five integrated community teams for adults with learning disabilities (CTLDs) in an English county-wide service, the use of psychotropic medication for service users was based on the presence of an appropriate mental health condition or epilepsy.

Design/methodology/approach

Adult participants were recruited following referral to one of the CTLDs for assessment, treatment and/or support of a possible mental health and/or behavioural need. Data were collected about participant characteristics and psychotropic medication 12 months after recruitment.

Findings

While a total of 42 (78 per cent) of the 54 participants were apparently prescribed regular or PRN (as required) psychotropic medication, only 24 (57 per cent) of these individuals had a recorded past or current mental health condition or epilepsy for which such medicine could be appropriate.

Research limitations/implications

There were several limitations: the sample size was small and its representativeness was uncertain; and data collection was compromised by barriers to explicit knowledge exchange within and across the learning disability service.

Practical implications

While recent guidance about the use of psychotropic medication is welcome, minimising inappropriate use requires more comprehensive person-centred interventions (including crisis management plans), underpinned by imaginative, but feasible, data collection methods and integrated formulations. Investment is needed in developments that support multi-disciplinary and inter-agency working to promote “good practice” by CTLDs in responding to referrals for possible mental health and/or behavioural needs.

Originality/value

Complementing recent large studies of primary care (General Practitioner) records, this is the first examination of the use of psychotropic medication by service users in English CTLDs.

Keywords

Acknowledgements

The authors are grateful to Liz Jones, Alison Lillywhite and Nadine Raenke for collecting the data, to the service user and care-giver participants, and the learning disability service for their support. The study was funded initially by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Cambridgeshire and Peterborough and then by the NIHR CLAHRC East of England at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Erratum It has been brought to the attention of the publisher that due to an error introduced at the production process, there is an error in the alignment of rows in Table I of the article “The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities”, published in Tizard Learning Disability Review, Vol. 23 No. 1, pp. 12-21. The online version has been corrected. Emerald and its typesetter sincerely apologise to the authors for any inconvenience caused.

Citation

Clare, I.C.H., Wade, K.A., Bolton, S., Wagner, A.P., Steven, T. and Holland, A.J. (2018), "The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities", Tizard Learning Disability Review, Vol. 23 No. 1, pp. 12-21. https://doi.org/10.1108/TLDR-02-2017-0009

Publisher

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Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited

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