Quality statement 5: Annually documenting the reasons for continuing antipsychotic drugs

Quality statement

People with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.

Rationale

People with learning disabilities who are taking medication for a mental health problem would benefit from closer monitoring and a clear rationale for their treatment plan, such as an annual record of the reasons for continuing prescriptions. People with learning disabilities are often given long courses of medication. This is not always helpful, and regular review and agreed shared care protocols are necessary to avoid this.

Effective use of medication to prevent and manage mental health problems is likely to improve the quality of life of people with learning disabilities and their family members and carers, and reduce costs and inappropriate prescribing.

Quality measures

Structure

Evidence of local arrangements to ensure that people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.

Data source: Local data collection.

Process

Proportion of people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped and who have annual documentation on reasons for continuing this prescription.

Numerator – the number in the denominator who have annual documentation on reasons for continuing this prescription.

Denominator – the number of people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped.

Data source: Local data collection.

Outcome

a) Antipsychotic medication prescribing rates for people with learning disabilities.

Data source: Local data collection.

b) Quality of life of people with learning disabilities and their family members and carers.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (secondary care providers) ensure that people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.

Healthcare professionals (clinicians) annually document the reasons for continuing prescriptions for people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped.

Commissioners (NHS England) commission services that ensure that people with learning disabilities who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.

People with learning disabilities who are taking antipsychotic drugs (medication to help with psychosis) that are not reduced or stopped have a review of their prescription and the reasons for continuing it recorded every year.

Source guidance

Mental health problems in people with learning disabilities: prevention, assessment and management (2016) NICE guideline NG54, recommendation 1.10.8

Equality and diversity considerations

Healthcare professionals should take into account the communication needs of people with learning disabilities. They should make reasonable adjustments and provide support if needed for people who have limited or no speech, who have difficulty with English, or who have other communication needs.

Communication with the person and their family members, carers or care workers (as appropriate) needs to be in a clear format and in a language suited to the person's needs and preferences.