Factors Influencing the Deprescribing of Psychotropic Medication in LD
Research type
Research Study
Full title
Factors Influencing the Deprescribing of Psychotropic Medication within a Community Learning Disability Population
IRAS ID
309255
Contact name
Jennie Day
Contact email
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Currently within the UK, it is estimated that 35,000 adults with learning disabilities (LD) are taking psychotropic medication daily in the absence of a diagnosed mental health condition. Current data collected from GP practice systems reveal that rates of prescribing antipsychotics, benzodiazepines and antidepressants are significantly higher within a LD population compared to individuals without a LD (NHS Digital, 2021). Despite data suggesting this is a longstanding problem, this remains a challenge that persists to the present day. Therefore, the aim of this project is to gain an understanding of the factors which are important in the clinical decision-making process when deciding to stop and/or reduce the use of psychotropic medication within a community learning disability population.
There are two main stages for the project:
Stage 1 – Gathering of statements to be included in a Q-sort for stage 2. These will be collected from published literature, grey literature, and qualitative interviews with people with learning disabilities, their carers, and health professionals to inform construction of the Q-sort. Interviews will be semi-structured, discussing patient experiences of being prescribed psychotropic medications.
Stage 2 – Administration of the Q-sort to health professionals, who will be recruited from Community LD teams within NHS trusts in the North-west. Q-methodology is a social constructionist method which combines both qualitative and quantitative methods in order to identify characteristics of individuals who share common viewpoints. The Q-sort will be made of statements created from the data gathering in stage 1 and will ask health professionals to rank-order statements in response to “When thinking about making decisions to stop or reduce medication for people with a learning disability how much do you agree or disagree with the following statements?”. Analysis of the Q-sorts will be completed using ‘PQMethod’ software.
LAY SUMMARY OF STUDY RESULTS
Q-methodology was used for this study revealing three distinct factors as follows:
- Willingness to deprescribe and try alternatives
- Risk and behaviours that challenge are a rationale for not deprescribing,
- Professional opinions, rational clinical judgement and safe ethical practiceThis study has identified viewpoints from NHS healthcare staff who work in community learning disability teams regarding their perspectives on factors which are influential in the deprescribing process of psychotropic medications within a learning disability population. The findings demonstrate differences in the way staff think about and approach deprescribing.
Factor one – in line with STOMP guidelines, reassuring, ppts in this factor showed a willingness to deprescribe and try alternatives to medications…
Factor two – more risk averse, worried about blame / fear in decision making, don’t feel GPs are happy to collaborate and work together in deprescribing psychotropics
Factor three – highly value professional judgement and decisions, feel that staff follow and work within recommended guidelines
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
22/WM/0136
Date of REC Opinion
1 Aug 2022
REC opinion
Further Information Favourable Opinion