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In the first of four blogs to mark the launch of today’s drive by NHS England urging doctors and other healthcare professionals to sign up to a national pledge to Stop the Over Medication of People with a learning disability, autism or both (STOMP), a pharmacist explains how it is having a positive impact on people’s lives:
For the last seven years I have worked directly with people with a learning disability, autism or both.
But before this I knew very little about learning disability and assumed it was an area of my work where there was little chance of making a difference.
I started working with a number of in-patient units which helped me to understand and share the hopes and fears of people with a learning disability, autism or both and what changes I needed to make in my practice to enable me to effect lasting change.
I then started working in a community learning disability team in Sunderland which meant that I needed to consider the needs of people living in the community, which helped with the national agenda of treating people at home and not in hospital.
That work also opened the door to using my non-medical prescribing qualification to take on my own caseload and help to make sure that people were getting the most appropriate medication.
This led me to think about the part I could play in NHS England’s call to action to reduce inappropriate prescribing of psychotropic medications being used to control behaviour for people with a learning disability, autism or both.
The STOMP programme has been close to my heart ever since. As a pharmacist, usually driven by guidelines and evidenced based medicine, it is really difficult to continue prescribing strong medications that have little or no rationale for use in controlling people’s behaviour.
In both the Sunderland and Newcastle community teams I have been allowed to develop a STOMP clinic working with behavioural nurse specialists and psychologists using Positive Behavioural Support (PBS) to manage behaviour in a different way than just reaching for the prescription pad.
We identify people who need to have a STOMP review with the potential to reduce and maybe even stop unwanted medications. This is a powerful collaborative approach pulling in everyone involved in the care of a person to consider a joined up approach to their ongoing support. The clinic can access all healthcare professionals for advice including speech and language therapists, dietitians, occupational therapists and physiotherapists.
To date we have taken eight people off all of their psychotropic medication with a further six undergoing a reduction plan where they are receiving less than half the medication they started with. The work is slow and involves winning the hearts and minds of families, carers and people with a learning disability, autism or both themselves.
People have strong opinions about the way medication should be used and a large part of my current role is to educate people about why STOMP is so important. Listening to people with a learning disability, autism or both and the people who care for them is vital to getting this right.
It is humbling to see a person’s quality of life improve as unwanted medication is removed and the person and their care team develop a far greater level of activity and positive interaction.
Working as part of a dedicated STOMP team is the most rewarding job I have ever had.