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Stopping the over medication of people with learning disabilities and autism

Research has found psychotropic medication could be inappropriately prescribed to as many as 35,000 people with learning disabilities and autism. By working with NHS initiative STOMP, we’re changing how we support people with their medication.

STOMP stands for ‘stopping the over medication of people with learning disabilities and/or autism’.

Medication matters

Unnecessary use of these ‘chemical restraint’ drugs can put people at risk of significant weight gain, organ failure and even premature death. With modern approaches to behaviour support, ongoing prescribing of such drugs is often completely unnecessary.

Having reviewed the medication records of everyone Dimensions supports, we have concluded that many people we support could be at risk of over medication. And we’re making some unshakable commitments.

We’re keeping the people we support at the centre of their medication plans.

Jackie Fletcher, Dimensions’ Quality Director comments: “Dimensions has been working with the NHS STOMP initiative since its inception. Having undertaken a review of medication records for many of the people we support, we now believe a number of individuals would benefit from changed or reduced prescriptions.

“As a result, Dimensions is now committing to work with GPs to review all psychotropic prescriptions for people we support over the next 12 months, with a view to reducing that medication where appropriate.”

How Dimensions is tackling over medication

STOMP forms a key part of Dimensions’ Health and Wellbeing Strategy. We have developed policy, practical tools, bespoke training modules and communication around STOMP to help tackle the problem.

We are aiming for 100% adherence to the guidelines for people currently prescribed psychotropics, and those prescribed in the future.

We will commit to working with GPs to achieve twice yearly, multi-disciplinary reviews for anyone taking prescribed psychotropics. We want to ensure that no matter what their disability, the person is at the centre of the prescription and review process, and is actively and meaningfully involved along with family members and advocates.

“Today I’ve attended a psychiatry review with a person we support. During the appointment I mentioned Dimensions commitment to the STOMP initiative and asked about a stoppage/reduction plan. This then lead to some interesting conversations about our use of positive behaviour support/positive reinforcement as an alternative to medication and took the review in a totally different direction. The outcome is an agreed five year stoppage/reduction plan.” – Dimensions Locality Manager

We commit to including an explicit medication reduction strategy within the individual’s support documentation.

STOMP’s background

Various studies show that people with learning disabilities and autism are at particular risk of over-medication with psychotropics. Many people have been prescribed psychotropics for all sorts of reasons and these prescriptions have just continued without the proper review – sometimes for years.

STOMP aims to reduce the amount of psychotropics being prescribed to people with learning disabilities and autism, which is an estimated 30,000 – 35,000 people currently wrongly prescribed.

STOMP is about:

  • improving people’s lives
  • helping people live longer and giving families more time with their loved ones
  • stopping psychotropics being used to control behaviour

The development of truly personalised support packages needs to ensure that any medications are prescribed in the context of the wider support plan.

For example, if a person is taking medication for depression, what other strategies are in the support plan to address the causes of the depression and alleviate the need for the medication?

Research suggests that controlled withdrawal can often be successful. A study in 2012 looked at the effects of controlled withdrawal of antipsychotics used for challenging behaviour.

Nearly half of those taking part were successful in stopping completely, and at follow-up just one in six had been subsequently put back onto antipsychotics.