Intellectual Disability
Conditions
Keywords
Intellectual Disability, Learning Disability, Anti-psychotic treatments, Over-prescribing, Psychotropic
Brief summary
The overall aim of this observational study is to establish the anti-psychotic prescribing patterns across specialist intellectual disability (ID) services in England and Wales by collecting cross-sectional retrospective data at 7 annual time-points (1st July) from 2017 to 2023.
Detailed description
Feasibility protocol objectives: 1. Is it feasible to identify People with Intellectual Disabilities (PwID) who have been prescribed 2 or more anti-psychotic medications over 7 years retrospectively. 2. It is possible to obtain a complete data set for each patient identified and therefore be able to explore the prescribing patterns across the eight sites. 3. Is it feasible to quantify anti-psychotic treatment (APT) prescribing in PwID as chlorpromazine equivalent dose values across different healthcare Trusts in England and Wales. Main objectives: 4. To explore yearly and overall prescribing patterns among PwID (with or without mental-health reasons (psychiatric co-morbidities)) in receipt of ≥2 forms of anti-psychotic treatment (multiple) over time? 5. How has multiple anti-psychotic treatment prescribing changed between 2017 and 2023 using chlorpromazine equivalent dose values, in PwID with mental health and no mental health indications? 6. What has been the impact of the COVID-19 pandemic (and corresponding lockdown restrictions in England and Wales) on multiple anti-psychotic treatment prescribing among PwID? 7. Can the NHS England Statistical Process Control tool (SPC) be utilised to track yearly anti-psychotic treatment prescribing among PwID receiving multiple forms of anti-psychotic treatment, and monitor variation between services (sites) and patient groups (e.g. psychiatric co-morbidities; challenging behaviour).
Interventions
None listed
Sponsors
University of Plymouth
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient had psychiatric review by specialist adult ID services in the last year (e.g. for a patient to be included at 1st June 2017, data to be recorded from the most recent psychiatric review within the period between 1st January 2017 - 31st December 2017). * Patient has a diagnosis of ID * Patient under the care of specialist adult ID services * Patient on \>2 anti-psychotic treatments (oral and IM injectable (depots))
Exclusion criteria
* Patients treated with Clozapine * Under the age of 18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The differences in chlorpromazine equivalent dose values in PwID prescribed multiple anti-psychotic treatment across the 7-annual timepoints and across the 8 sites. | 2017-2023 | Main objective: To explore yearly and overall prescribing patterns among PwID (with or without mental-health reasons (psychiatric co-morbidities)) in receipt of ≥2 forms of anti-psychotic treatment (multiple) over time. |
| The differences in chlorpromazine equivalent dose values in PwID prescribed multiple anti-psychotic treatment, with mental health indications, compared to those with no mental health indications between 2017 and 2023. | 2017-2023 | Main objective: How has multiple anti-psychotic treatment prescribing changed between 2017 and 2023 using chlorpromazine equivalent dose values, in PwID with mental health and no mental health indications? |
| The differences in chlorpromazine equivalent dose values in PwID prescribed multiple anti-psychotic treatment before, during and after the COVID-19 pandemic. | 2017-2023 | Main objective: What has been the impact of the COVID-19 pandemic (and corresponding lockdown restrictions in England and Wales) on multiple anti-psychotic treatment prescribing among PwID? |
| SPC will be used to compare trends in multiple APT prescribing within/across participating healthcare trusts and utilised to track yearly oral/depots anti-psychotic treatment prescribing and monitor variation between services & patient groups. | 2017-2023 | Main objective: Can the SPC be utilised to track yearly anti-psychotic treatment prescribing among PwID receiving multiple forms of anti-psychotic treatment, and monitor variation between services (sites) and patient groups (e.g. psychiatric co-morbidities; challenging behaviour)? |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number (%) of PwID with a complete data set. | Through study completion, an average of 6 months | Feasibility objective: Is it possible to obtain a complete data set for each patient identified and therefore be able to explore the prescribing patterns across the eight sites? |
| Number (%) for whom it was feasible to quantify oral and depots anti-psychotic treatment prescribing in PwID as chlorpromazine equivalent dose values across different healthcare trusts in England and Wales. | Through study completion, an average of 6 months | Feasibility objective: Is it feasible to quantify anti-psychotic treatment (oral and long-acting IM injectables (depots) prescribing in PwID as chlorpromazine equivalent dose values across different healthcare Trusts in England and Wales? |
| Number (%) of PwID successfully identified who have been prescribed more than 2 anti-psychotic medications yearly over 7. | Through study completion, an average of 6 months | Feasibility objective: Is it feasible to identify PwID who have been prescribed 2 or more anti-psychotic medications over 7 years retrospectively? |
Countries
United Kingdom
Contacts
Primary ContactProfessor Shankar
Backup ContactEmily Stanyard
Outcome results
None listed