Note: Some sections of this case study refer to clinical commissioning groups (CCGs). On 1st July 2022, integrated care systems (ICSs) took over statutory commissioning responsibilities in England, and CCGs were closed down. You can learn more about integrated care systems (ICSs) here.
Case study summary
A group of pharmacists from Bury Clinical Commissioning Group and Pennine Care NHS Foundation Trust have been looking at how they could make sure that local people with a learning disability, autism or both, are given the right medicines, for the right reason, at the right time.
Following on from the NHS England’s Stopping Over-Medication of People (STOMP) campaign the group decided to look at how they could make sure people in their area are only given the right medicines, for the right reason, in the right amount, for as short a time as possible.
This is because it is estimated that every day about 35,000 people with a learning disability, autism or both are prescribed psychotropic medicines which they might not need. A psychotropic medicine affects how the brain works and includes medicines used to treat psychosis, depression, anxiety, sleep problems and epilepsy. These medicines are often used to manage behaviour which is seen as challenging.
Working together with the town’s 30 GP practices the team looked at the lists held by GPs of which patients have a learning disability and were prescribed these types of medicines. They looked at why people were taking them, how much they were taking and what health checks and blood tests each person had had done.
They found out that of the 195 people who were prescribed an antipsychotic, 65% had been given this medication for challenging behaviour. They also found people who were taking more than one antipsychotic and people who were taking medicine in higher than recommended doses.
Following this pharmacists, consultants and GPs worked together with people and their families and carers to develop a personal action plan to help them reduce the amount of medicines been taken. Each person was given support to manage their symptoms and a check up on how things were going once a month. Anyone needing extra support was referred to the community learning disability team.
Bury CCG’s Clinical Lead for Medicines Optimisation and Learning Disabilities, Nigget Saleem says: “As health professionals it is our duty to make sure that these medications are used appropriately. I have seen how involving people in making decisions and supporting them to follow a steady reduction plan can give them much happier lives”.