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Pragmatic Reasonable Accommodation in Everyday Medicine for People With Intellectual Disabilities: A Qualitative
Masaki Shoji1, Rintaro Imafuku2, Mei Mizomoto3
1Department of Social and Administrative Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Background:
In Japan, providing reasonable accommodation for people with intellectual disabilities became mandatory on 1 April 2024, but evidence from non-psychiatric hospital care is limited.
Method:
We conducted semi-structured interviews with nine hospital-based non-psychiatric physicians in Japan (October 2023-March 2024) and analysed data using inductive thematic analysis.
Results:
Physicians described accommodations in (1) medication management tailored to understanding, preferences, and home support; (2) relationship-centred communication to elicit symptoms and confirm comprehension; and (3) flexible care processes, including time, environment, and team roles. They mitigated risks through witnessed explanations, clear documentation, and proactive coordination with nurses and family members.
Conclusions:
Practical, workflow-embedded accommodations are common in non-psychiatric settings and could be strengthened by structured communication supports and systematic information sharing.
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