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Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service

Published online by Cambridge University Press:  02 January 2018

Tom Marshall*
Affiliation:
Nottinghamshire Healthcare NHS Trust, Byron House, Newark Hospital, Boundary Road, Newark NG24 4DE
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Abstract

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Aims and Method

The aims of the study were to identify patients in a community learning disability service receiving psychotropic medication for challenging behaviour, to examine prescribing practice and to compare this against local consensus standards. Local consensus standards were agreed by the consultants and the notes were reviewed by the author.

Results

A total of 102 patients were identified as receiving psychotropic medication for challenging behaviour (26.7% of notes examined). The most common additional diagnoses were autism (29%) and epilepsy (28%). The average duration of treatment was 5.3 years, and multiple drugs were used in 34% of these patients. Antipsychotics were the most commonly used drugs (96% of patients). There was rarely a detailed description of the challenging behaviour. There was little regular monitoring of side-effects or warning about potential side-effects when the medication was started.

Clinical Implications

Challenging behaviour is a common cause of multiple prescribing in learning disability patients, and is often long-term in the absence of a strong evidence base. Other specialties use medication to control disturbed behaviour, particularly in people with dementia or personality disorder, so this audit may also be of interest to old age, adult and forensic psychiatrists.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2004. The Royal College of Psychiatrists.

References

Ahmed, Z., Fraser, W., Kerr, M. P., et al (2000) Reducing antipsychotic medication in people with a learning disability. British Journal of Psychiatry, 176, 4246.CrossRefGoogle Scholar
Bhaumik, S. & Michael, D. M. (2004) Pharmacotherapy and pharmacovigilance in learning disability. Learning Disability Psychiatry, 6, 910.Google Scholar
Branford, D. (1994) A study of the prescribing for people with learning disabilities living in the community and National Health Service Care. Journal of Intellectual Disability Research, 38, 577586.CrossRefGoogle ScholarPubMed
Brylewski, J. & Duggan, L. (1999) Antipsychotic medication for challenging behaviour in people with intellectual disability: a systematic review of randomised controlled trials. Journal of Intellectual Disability Research, 43, 360371.Google Scholar
Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. London: Department of Health.Google Scholar
Emerson, C. (1995) Challenging Behaviour. Analysis and Intervention in People with Learning Difficulties. Cambridge: Cambridge University Press.Google Scholar
Kiernan, C. & Alborz, A. (1996) Persistence and change in challenging and problem behaviours of young adults with intellectual disability living in the family home. Journal of Applied Research in Intellectual Disabilities, 9, 181193.Google Scholar
Kiernan, C., Reeve, D. & Alborz, A. (1995) The use of anti-psychotic drugs with adults with learning disabilities and challenging behaviour. Journal of Intellectual Disability Research, 39, 263274.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (2001) DC–LD: Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/ Mental Retardation. Occasional Paper OP48. London: Gaskell.Google Scholar
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