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• Deprescribing in the population with learning/intellectual disabilities
  Bernadette Flood
  Published on: 27 March 2017

• Published on: 27 March 2017

  Deprescribing in the population with learning/intellectual disabilities

  • Bernadette Flood, Pharmacist

  Vulnerable populations are vulnerable because they are susceptible to harm in health care environments. It is important that the healthcare issues specific to the population with learning/intellectual disabilities are considered when prescribing and deprescribing.

  Deprescribing tools must be validated in the population with learning/intellectual disabilities to ensure safety and quality care. People with learn...

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  Vulnerable populations are vulnerable because they are susceptible to harm in health care environments. It is important that the healthcare issues specific to the population with learning/intellectual disabilities are considered when prescribing and deprescribing.

  Deprescribing tools must be validated in the population with learning/intellectual disabilities to ensure safety and quality care. People with learning/intellectual disabilities and behaviour disorders provide particular challenges.

  In the population with learning/intellectual disabilities compared to the general population, the multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs [1].

  People with learning/intellectual disabilities use multiple medications and may have been taking them for many years. Extreme care in required when de- prescribing many medications in this population group.

  The principles of good de-prescribing during medication review in the population with learning/intellectual disabilities, based on the British Pharmacological Society's Principles for Good Prescribing 2010, provide a template for quality de-prescribing in this population group.

  Principles of Good De-prescribing during Medication Review in the Population with Learning/Intellectual Disabilities (and Behaviour Disorders). Based on the British Pharmacological Society's Principles for Good Prescribing 2010 1. Be clear about the reasons for de-prescribing. 2. Take into account the patient with learning/intellectual disabilities and behaviour disorders medication history before de-prescribing. 3. Take into account other factors that might alter the benefits and risks of de-prescribing treatment in the patient with learning/intellectual disability and behaviour disorders. 4. Take into account the patient's/carer's/families/advocates ideas, concerns, and expectations. 5. Ensure all medicines are effective, safe, cost-effective in appropriate form individualised for the patient with learning/intellectual disability, behaviour disorders and other conditions such as dysphagia, autism. 6. Adhere to national guidelines and local formularies where appropriate. Use caution where the population with learning/intellectual disability have not been considered in the guideline development process. 7. Write unambiguous correct documentation detailing reason for de- prescribing. 8. Monitor the beneficial and adverse effects of de-prescribing medicines and any effects on behaviour. 9. Communicate and document all de-prescribing decisions and the reasons for them such as transferred to appropriate personnel such as GP, pharmacist, psychiatrist, epileptologist, carer and patient. 10. De - prescribe within the limitations of your knowledge, skills and experience of the population with learning/intellectual disabilities and behaviour disorders.

  1. Cooper S-A, McLean G, Guthrie B, et al. Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis. BMC Family Practice. 2015;16:110. doi:10.1186/s12875-015-0329-3.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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