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A structured medication review tool to promote psychotropic medication optimisation for adults with intellectual

Rory Sheehan¹, André Strydom², Louise Marston³

¹Division of Psychiatry, University College London, London, UK r.sheehan@ucl.ac.uk.

|December 18, 2019

Abstract

Objectives:

To investigate the feasibility of delivering structured psychotropic medication review in community services for adults with intellectual disability (ID).

Design:

Single-arm feasibility study conducted over a 6-month period.

Setting:

Specialist community ID teams in England.

Participants:

Psychiatrists working with adults with ID and adults with ID who had been prescribed psychotropic medication.

Intervention:

A structured web-based psychotropic medication review tool (the HealthTracker-based structured medication review) comprising measures of therapeutic benefit and adverse side-effects was made available for use by psychiatrists in routine clinic appointments. A summary measure of medication effectiveness was graphically presented to aid discussion and decision-making.

Main Outcome Measures:

Feasibility metrics including number of people with ID referred, eligible and recruited, and uptake of the medication review tool in naturalistic clinical settings. Psychiatrist and patient feedback was collected to assess acceptability of the intervention and suggestions for development.

Results:

Fifteen psychiatrists from five clinical teams took part. In total 94 potentially eligible people with ID were referred, of whom 79 (84%) were recruited and together underwent 97 medication reviews over the 6-month study period. Feedback from participants with ID was favourable. Psychiatrists indicated that the HealthTracker-based structured medication review was broadly acceptable and suggested adaptations to improve integration with existing information technology systems and to enhance patient involvement in the review.

Conclusions:

Structured psychotropic medication review can be used in community services for adults with ID as part of a programme of medication optimisation. It would be feasible to test clinical and patient outcomes of the HealthTracker-based medication review in a randomised clinical trial.

Keywords:

feasibility study intellectual disability medication optimisation medication review psychotropic medication

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