Quality standard
Quality statement 5: Annually documenting the reasons for continuing antipsychotic drugs
Quality statement 5: Annually documenting the reasons for continuing antipsychotic drugs
Quality statement
People with a learning disability who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.
Rationale
People with a learning disability 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 a learning disability 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 a learning disability and their family members and carers, and reduce costs and inappropriate prescribing.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that people with a learning disability who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example care protocols.
Process
Proportion of people with a learning disability 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 a learning disability who are taking antipsychotic drugs that are not reduced or stopped.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
Outcome
a) Antipsychotic medication prescribing rates for people with a learning disability.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
b) Quality of life of people with a learning disability and their family members and carers.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient surveys.
What the quality statement means for different audiences
Service providers (secondary care providers) ensure that people with a learning disability 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 a learning disability who are taking antipsychotic drugs that are not reduced or stopped.
Commissioners commission services that ensure that people with a learning disability who are taking antipsychotic drugs that are not reduced or stopped have annual documentation on reasons for continuing this prescription.
People with a learning disability 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. NICE guideline NG54 (2016), recommendation 1.9.8
Equality and diversity considerations
Healthcare professionals should take into account the communication needs of people with a learning disability. 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.