The Faculty of Psychiatry of Intellectual Disability part of The Royal College of Psychiatrists has today published practice guidelines for psychotropic drug prescribing for people with intellectual disability, mental health problems and/or behaviours that challenge.
In their executive summary they outline the following:
Standards for psychotropic drug prescribing:
- The indication(s) and rationale for prescribing the psychotropic drug should be clearly stated, including whether the prescribing is off-label, polypharmacy or high dose.
- Consent-to-treatment procedures (or best-interests decision-making processes) should be followed and documented.
- There should be regular monitoring of treatment response and side-effects (preferably every 3 months or less, at a minimum every 6 months).
- Review and evaluation of the need for continuation or discontinuation of the psychotropic drug should be undertaken on a regular basis (preferably every 3 months or less, at a minimum every 6 months) or whenever there is a request from patients, carers or other professionals.
Recommendations
- All psychotropic prescribing should adhere to the four prescribing standards above.
- All initiations of psychotropic drugs for people with intellectual disability, whether from pri- mary or secondary care, should be by a prescriber who is competent in the care of people with intellectual disability.
- Psychotropic drug prescribing should be seen as part of a wider multidisciplinary and holistic care plan.
- Regular reviews of the drugs should occur either according to NICE quality standards or when requested by the patient, carer or other professionals.
- There should be a national audit on prescrib- ing practice that takes into account all the standards mentioned above.
- Regulators and commissioners should use these standards for quality checks on services.
You can download the practice guidelines here.