Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study

Overprescribing psychotropic medication for people with intellectual disabilities increases the risk of adverse effects and has prompted deprescribing initiatives internationally. However, factors that support optimal psychotropic deprescribing in this population remain unclear. The aim of this stud...

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Main Authors: Danielle Adams, Richard P. Hastings, Ian Maidment, Peter E. Langdon
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1652988/full
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author Danielle Adams
Danielle Adams
Richard P. Hastings
Ian Maidment
Peter E. Langdon
Peter E. Langdon
Peter E. Langdon
author_facet Danielle Adams
Danielle Adams
Richard P. Hastings
Ian Maidment
Peter E. Langdon
Peter E. Langdon
Peter E. Langdon
author_sort Danielle Adams
collection DOAJ
description Overprescribing psychotropic medication for people with intellectual disabilities increases the risk of adverse effects and has prompted deprescribing initiatives internationally. However, factors that support optimal psychotropic deprescribing in this population remain unclear. The aim of this study is to develop consensus within the UK about factors supporting optimal psychotropic deprescribing using an online Delphi study. A modified Delphi study with two rounds was distributed via QualtricsXM to a panel of UK healthcare professionals working with people with intellectual disabilities. Thirty-four factors derived from research were presented in round 1 and rated on a 5-point Likert-type scale. Ten factors were presented in round 2 comprising of items not achieving ≥85% consensus in round 1. Participants were able to suggest additional factors in round 1. The key finding was a set of 33 factors supporting optimal psychotropic deprescribing that achieved consensus. Following the round 1 questionnaire, 28 statements reached consensus. Key factors related to attitudes, confidence, conflict resolution, person-centred care, shared decision-making, adherence to guidelines, and mutual learning and support. Following round 2, consensus was reached on five further statements, including two derived from free text responses in round 1. Consensus was reached on 33 factors judged important to promote the safe and effective deprescribing of psychotropic medication for people with intellectual disabilities within the UK. Future practice recommendations should promote equitable and sustainable deprescribing practices informed by experiences of carers and individuals with intellectual disabilities.
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spelling doaj-art-124d5ecccd1c4f9989d6cd5bb49b46ef2025-08-20T03:07:35ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-08-011610.3389/fpsyt.2025.16529881652988Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi studyDanielle Adams0Danielle Adams1Richard P. Hastings2Ian Maidment3Peter E. Langdon4Peter E. Langdon5Peter E. Langdon6Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, United KingdomHertfordshire Partnership University NHS Foundation Trust, Hatfield, United KingdomIntellectual Disabilities Research Institute (IDRIS), University of Birmingham, Birmingham, United KingdomCollege of Health and Life Sciences, Aston University, Birmingham, United KingdomIntellectual Disabilities Research Institute (IDRIS), University of Birmingham, Birmingham, United KingdomBirmingham Community Healthcare NHS Foundation Trust, Birmingham, United KingdomHerefordshire and Worcestershire Health and Care NHS Trust, Worcester, United KingdomOverprescribing psychotropic medication for people with intellectual disabilities increases the risk of adverse effects and has prompted deprescribing initiatives internationally. However, factors that support optimal psychotropic deprescribing in this population remain unclear. The aim of this study is to develop consensus within the UK about factors supporting optimal psychotropic deprescribing using an online Delphi study. A modified Delphi study with two rounds was distributed via QualtricsXM to a panel of UK healthcare professionals working with people with intellectual disabilities. Thirty-four factors derived from research were presented in round 1 and rated on a 5-point Likert-type scale. Ten factors were presented in round 2 comprising of items not achieving ≥85% consensus in round 1. Participants were able to suggest additional factors in round 1. The key finding was a set of 33 factors supporting optimal psychotropic deprescribing that achieved consensus. Following the round 1 questionnaire, 28 statements reached consensus. Key factors related to attitudes, confidence, conflict resolution, person-centred care, shared decision-making, adherence to guidelines, and mutual learning and support. Following round 2, consensus was reached on five further statements, including two derived from free text responses in round 1. Consensus was reached on 33 factors judged important to promote the safe and effective deprescribing of psychotropic medication for people with intellectual disabilities within the UK. Future practice recommendations should promote equitable and sustainable deprescribing practices informed by experiences of carers and individuals with intellectual disabilities.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1652988/fullintellectual disabilitiesDelphipsychotropic medicationdeprescribingmedicines optimisation
spellingShingle Danielle Adams
Danielle Adams
Richard P. Hastings
Ian Maidment
Peter E. Langdon
Peter E. Langdon
Peter E. Langdon
Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
Frontiers in Psychiatry
intellectual disabilities
Delphi
psychotropic medication
deprescribing
medicines optimisation
title Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
title_full Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
title_fullStr Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
title_full_unstemmed Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
title_short Factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the UK: a modified Delphi study
title_sort factors supporting optimisation of psychotropic deprescribing in people with intellectual disabilities within the uk a modified delphi study
topic intellectual disabilities
Delphi
psychotropic medication
deprescribing
medicines optimisation
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1652988/full
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