Reducing antipsychotic medication in ID using QI methodology

Advances in Mental Health and Intellectual Disabilities, Ahead of Print. Purpose Research highlights that antipsychotic medications are prescribed more in people with Intellectual Disability (ID) without a diagnosis of severe mental illness. Despite non-pharmacological interventions recommended as alternatives, their application can be challenging due to heterogeneity of the patient group. The purpose of this paper is to discuss application of quality improvement (QI) methodology in adapting interventions, aiming to reduce challenging behaviour of people with ID, thereby reducing use of antipsychotic medication. Design/methodology/approach Two interventions were introduced as “tests of change”; an “Attention-Deficit Hyperactivity Disorder (ADHD) clinic” and “Positive Behaviour Support (PBS) clinic”. Process (Clinical Global Impression (CGI) and Modified Overt Aggression Scale (MOAS)) and outcome measures (total antipsychotic use) were used to assess the inter ventions, with each being reviewed as per QI methodology guidelines. Findings There was an improvement in CGI scores for both interventions. MOAS scores reduced for those attending the ADHD clinic, resulting in reductions of antipsychotic medication. MOAS scores did not reduce for the PBS clinic, so there was no reduction in medication for this group. Originality/value Based on the introduction of pilot clinics, this paper provides a commentary on how QI interventions can be used to evaluate and adapt evi...

Source: Advances in Mental Health and Intellectual Disabilities - June 26, 2019 Category: Disability Source Type: research