We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence use, reasons for and the relationship between these patient characteristics.A cross-sectional study medical pharmaceutical records in a population living residential settings three care providers persons with IDs Netherlands (n = 2373).Prevalence use was 32.2% (95% CI 30.1-33.9). Behavioural problems were reason drugs 58% cases psychotic disorder or symptoms 22.5%. In 11.7% diagnosis...

Abstract Background Antipsychotics are frequently and often long‐term used for challenging behaviour in persons with intellectual disability ( ID ), but the evidence base this is meagre. As these agents may cause harmful side effects, discontinuation should be considered. Previous studies regarding of antipsychotics mostly were uncontrolled involved small numbers. The primary objective was to investigate effects controlled prescribed behaviour. Secondary objectives compare results two time...

Abstract Background People with intellectual disability (ID) frequently use antipsychotic drugs on an off‐label base, often for many years. Physicians' decisions to discontinue these not only depend patient characteristics, like the presence of mental or behavioural disorders, but also environmental factors, such as inappropriate living circumstances, and attitudes, knowledge beliefs staff, clients their representatives towards effects drug use. In this study, we therefore investigated...

ABSTRACT Background We aimed to identify key factors in implementing and adhering positive behaviour support (PBS), provided by frontline staff, targeting challenging behaviours of people with intellectual disabilities living residential group homes. Method Using semi‐structured interviews 12 staff members, we collected perspectives on a PBS training that they received. In two separate focus groups nine members trainers, discussed perceived influence implementation adherence. Hybrid coding...

Purpose In intellectual disability healtcare, providing accessible information on treatment proposals is a necessary part of shared decision-making. However, although the medication use especially psychotropic drugs high, people with often lack knowledge about these prescriptions. Accessible written not available. The authors aimed to fill this gap. Design/methodology/approach Four individuals (the panel), their coach, pharmacists and healthcare professionals/researchers collaborated in...

Abstract Background In people with intellectual disabilities and mental disorders and/or challenging behaviours, rates of psychotropic drug prescription are high. clinical treatments evaluations, all stakeholders should be involved in a process shared decision‐making (SDM). We aimed to investigate the perspectives clients their carers on clients’ drugs. Methods conducted survey among adults Dutch healthcare centre providing community, outpatient inpatient care. Data were collected between...

Antipsychotics are frequently prescribed agents in individuals with intellectual disability, often for behavioral symptoms. Efficacy of antipsychotics this is ambiguous, so discontinuation should be considered. Weight gain and metabolic dysregulation well-known adverse effects which increase the risk syndrome. We performed a study 99 adults living residential facilities who used symptoms more than 1 year. The aim present was to investigate long-term on weight, body mass index (BMI),...

Abstract Although physicians are aware of the risks prescribing long‐term off‐label antipsychotics in people with intellectual disability, attempts to discontinue often fail. This study aimed identify potential determinants successful and failed discontinuation. Long‐term were tapered 14 weeks, 12.5% baseline dose every 2 weeks. Participants living facilities offered by disability service providers, ≥6 years, an IQ <70 eligible antipsychotic use, as judged their physicians. The primary...

Background/Introduction In this study, we investigated intellectual disability support professionals’ knowledge and expectations towards effects of psychotropic drug use on behaviour in their clients, because shortcomings may lead to misinterpretations behavioural symptoms inappropriate use. Methods Two self‐designed questionnaires were used measure the 194 professionals 14 residential facilities regarding antipsychotics behavioural, cognitive mental functioning people with disability. The...

Abstract Background Staff supporting individuals with intellectual disabilities are at risk of burnout symptoms. Evidence suggests an association between exposure to challenging behaviours and symptoms staff, but the protective role staff psychological resources in this relation has been understudied. Method We investigated direct moderating effects several resources. ( N = 1271) completed online survey concerning (subscale Emotional Exhaustion Maslach Burnout Inventory), a range potential...

Abstract Background Many people with intellectual disabilities use risperidone long term for the management of challenging behaviours, despite its limited proof effectiveness and clear association adverse events. Therefore, this study aimed to investigate ongoing treatment in reducing behaviours versus controlled discontinuation on behaviour health parameters. Method This was a placebo‐controlled, double‐blind, randomised trial risperidone. In group, gradually replaced by placebo over 14...

Background It is unknown why professionals’ adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care insufficient. This study aimed explore barriers and facilitators implementation use of these recommendations. Methods In‐depth interviews with four disability physicians, two psychiatrists five behavioural scientists were used Results Barriers adhering lack collaboration different disciplines involved treatment psychiatric disorders...

Abstract Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, availability PBS for individuals with intellectual disabilities is limited many countries including Netherlands. Training care staff supporting may be a way to improve provision PBS. We aimed explore preliminary training behaviors disabilities. Using one group, double pretest–posttest design, 24 members involved 11 adult and participated. assessed changes quality life individuals,...

International current best practice recommends the discontinuation of antipsychotics for challenging behaviours in people with intellectual disabilities (ID), due to lack evidence efficacy and risks harmful side-effects. In clinical practice, may be difficult. The aim this study was gain insight into prescribers’ by investigating their experiences long-term behaviour. From professionals’ associations thirty-four registered ID physicians, psychiatrists specialist mental healthcare nurses were...

Abstract Background Effects of staff provided positive behaviour support (PBS) for individuals with intellectual disabilities are unclear. Method Using a multicentre non‐randomised cluster controlled design, 26 teams residential group homes, including 245 members 167 disabilities, were allocated to PBS or control group. Conducting multilevel analyses ( n = 123) we examined individuals' changes in irritability, other challenging behaviours and quality life. Results Compared controls,...

Purpose Antipsychotic drugs are frequently prescribed to people with intellectual disabilities (ID) ameliorate psychotic symptoms and behavioural without mental condition. Guidelines recommend systematic evaluation of treatment effects adverse effects, limiting the duration. Studies have shown that adherence prescription guidelines is beneficial for clients’ outcomes. Therefore, purpose this paper investigate antipsychotic drug in two settings. Design/methodology/approach A checklist, based...

People with intellectual disabilities (PwID) are frequently prescribed long-term antipsychotics for behaviours that challenge (BtC) despite the lack of proven effectiveness and increased risks side effects these medications in this population. National international good clinical practice guidelines recommend deprescribing BtC, which is often not successful due to environmental other factors. The involvement all stakeholders, including PwID, crucial deprescribing. However, studies showed...

Abstract Background Results of discontinuation antipsychotics in people with intellectual disability are variable and may depend on staff factors. Method We attempted to taper off 14 weeks after which participants were free restart. investigated the influence support professionals’ feelings towards challenging behaviour, their knowledge psychotropic drugs clinicians’ judgements participants’ behavioural functioning whether or not completely discontinued 16, 28 40 weeks. Of 129 participants,...

Thyroid hormones (TH) are important for normal brain development and abnormal TH regulation in the results neurocognitive impairments. The type 2 deiodinase (D2) is local control by generating active hormone T3 from its precursor T4. Dysfunction of D2 likely a phenotype. No mutations have been reported yet.The objective study was to identify patients with intellectual disability test their functional consequences.The were selected multicenter Origin Psychomotor Retardation study, which...

Health-related quality of life in people with intellectual disabilities can be affected by challenging behaviors and side effects antipsychotics. The aim this study was to evaluate the effect discontinuation antipsychotic drugs on health-related life, including data from 2 trials: an open-label trial various a double-blind risperidone. In both studies, antipsychotics were discontinued 14 weeks, steps 12.5% baseline dosage every weeks. measured at 16 40 weeks after baseline, means RAND-36...

Service providers may experience difficulties in providing appropriate care to optimize the functioning of individuals with intellectual disability and challenging behaviour. External consultation identify address unmet support needs underlying behaviour be beneficial. Applying multidimensional American Association Intellectual Developmental Disabilities (AAIDD) model facilitate this approach. We aimed describe content outcomes for referred Dutch Centre Consultation Expertise relation AAIDD...