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Nurses asked to help stop ‘over-medication’ of people with learning disabilities

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Nurses and other health professionals are being urged to sign a national pledge to prevent the over-medication of people with autism and learning disabilities.

NHS England today put out a fresh call to nurses, doctors and others to support the Stopping Over-Medication of People with a Learning Disability campaign, known as STOMP.

“Everyone needs to be involved in the decision-making and clear about why such medication is needed”

John Trevains

The drive, which is backed by government, will target NHS trusts, clinical commissioning groups and the independent healthcare sector, calling on organisations to review the prescribing of psychotropic drugs and seek alternatives.

Currently, an estimated 35,000 adults with a learning disability, autism or both are being prescribed antipsychotics and antidepressants without appropriate clinical justification, according to the body.

Long-term use of these drugs can lead to significant weight gain, organ failure and even death in some cases.

The STOMP pledge was launched in 2016, supported by a number of professional bodies including the Royal College of Nursing. A pledge for social care followed in May 2017 and 60 providers that work with people with learning disabilities and autism have signed up.

“Like most people I am deeply concerned about the over prescribing of powerful medications”

Caroline Dinenage

NHS England said it now wanted to see all healthcare providers get on board. Those keen to get involved will need to show they have an action plan in place to meet guidelines on safe and ethical prescribing.

John Trevains, NHS England’s head of mental health and learning disability nursing, stressed that people should only receive psychotropic medication “when all other approaches have been considered”.

“Everyone, including the person with a learning disability, autism or both, and their families, needs to be involved in the decision-making and clear about why such medication is needed,” he said.

“They need to be aware of the serious side effects and understand how often and when the medication will be reviewed,” he added.

Often patients found to be on multiple drugs were initially prescribed these at specialist level to deal with challenging behaviour. Cases may then be passed on to primary care where prescriptions are simply repeated year after year without being properly reviewed.

“Medication has its place but needs to be used at the lowest dose for the shortest time”

Dave Gerrard

Dave Gerrard, an advanced pharmacist practitioner at Northumberland, Tyne and Wear NHS Foundation Trust, said he had come across people who’d been on such medication for more than 10 years without review.

“Medication has its place but needs to be used at the lowest dose for the shortest time before being challenged and reviewed. This to me is the essence of STOMP and something I believe passionately about,” said Mr Gerrard, who is joint pharmacist lead for STOMP at NHS England.

Care minister Caroline Dinenage, who has responsibility for learning disabilities and autism, also gave her support to the latest phase of the campaign, which got under way with an event in Newcastle.

“Like most people I am deeply concerned about the over prescribing of powerful medications to people with a learning disability, autism, or both to manage behaviours that are seen as challenging,” she said.

“I fully support the commitments to STOMP that aim to challenge this practice with a view to improving a person’s quality of life,” said Ms Dinenage.

“And I now challenge all healthcare providers to sign up to this important pledge initiative and truly focus their efforts to transform peoples’ lives,” she added.

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