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Deprescribing psychotropic medicines for behaviours that challenge in people with intellectual disabilities : a systematic review
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Adams, Danielle, Hastings, Richard P., Maidment, Ian, Shah, Chetan and Langdon, Peter E. (2023) Deprescribing psychotropic medicines for behaviours that challenge in people with intellectual disabilities : a systematic review. BMC Psychiatry, 23 . 202. doi:10.1186/s12888-022-04479-w ISSN 1471-244X.
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Official URL: http://doi.org/10.1186/s12888-022-04479-w
Abstract
Background
Clear evidence of overprescribing of psychotropic medicines to manage behaviours that challenges in people with intellectual disabilities has led to national programmes within the U.K. such as NHS England’s STOMP to address this. The focus of the intervention in our review was deprescribing of psychotropic medicines in children and adults with intellectual disabilities. Mental health symptomatology and quality of life were main outcomes.
Methods
We reviewed the evidence using databases Medline, Embase, PsycINFO, Web of Science, CINAHL and Open Grey with an initial cut-off date of 22nd August 2020 and an update on 14th March 2022. The first reviewer (DA) extracted data using a bespoke form and appraised study quality using CASP and Murad tools. The second reviewer (CS) independently assessed a random 20% of papers.
Results
Database searching identified 8675 records with 54 studies included in the final analysis.
The narrative synthesis suggests that psychotropic medicines can sometimes be deprescribed. Positive and negative consequences were reported. Positive effects on behaviour, mental and physical health were associated with an interdisciplinary model.
Conclusions
This is the first systematic review of the effects of deprescribing psychotropic medicines in people with intellectual disabilities which is not limited to antipsychotics. Main risks of bias were underpowered studies, poor recruitment processes, not accounting for other concurrent interventions and short follow up periods. Further research is needed to understand how to address the negative effects of deprescribing interventions.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||
Divisions: | Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) | ||||||
Library of Congress Subject Headings (LCSH): | Psychotropic drugs -- Prescribing, People with mental disabilities, Intellectual disability | ||||||
Journal or Publication Title: | BMC Psychiatry | ||||||
Publisher: | BioMed Central Ltd. | ||||||
ISSN: | 1471-244X | ||||||
Official Date: | 28 March 2023 | ||||||
Dates: |
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Volume: | 23 | ||||||
Article Number: | 202 | ||||||
DOI: | 10.1186/s12888-022-04479-w | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 21 December 2022 | ||||||
Date of first compliant Open Access: | 28 July 2023 | ||||||
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