A specialist learning disability nurse has spoken out against the over-medication of people with learning disabilities.
Anne Webster said it was a ‘human rights’ issue and had a major impact on quality of life.
Nurse Anne Webster: over-medicating people with learning disabilities is ‘a human rights issue’
She said it was important to investigate any underlying reasons for challenging behaviours in people with learning disabilities.
Professionals prescribe drugs
She said professionals often prescribe drugs instead of looking for these underlying reasons.
Webster works for NHS England. She is a clinical lead on Stopping Over-Medication of People with a Learning Disabilities (STOMPwLD).
STOMPwLD is an official pledge to stop the ‘historic problem’ of over-medication. The Royal Colleges of Nursing, the Royal Pharmaceutical Society, the British Psychological Society and NHS England all signed up to its launch last year. It supports prescribing healthcare professionals to review inappropriate prescriptions for people under their care if they have a learning disability and/or autism.
Webster said the emphasis was different when she qualified in the late 1980s. In those days, she said the focus was on training nurses to administer drugs. This would include understanding what the drugs were for, correct dosages, proper storage, record keeping and side-effects. It would not include challenging their use.
Questions raised about medication
However, Public Health England research in 2015 raised questions about medication. It produced a report, Prescribing of psychotropic drugs to people with learning disabilities and/or autism by general practitioners in England.
Public Health England found that doctors prescribed between 30,000 and 35,000 people with learning disabilities an antipsychotic, an antidepressant or both. They filled out the prescriptions without patients having the conditions that the drugs were designed to treat.
Human rights issue
In a blog for learningdisabilitynurse.com, Webster wrote: “This is a human rights issue, that can have a big impact on people’s quality of life as well as a health inequality.”
Webster said learning disability nurses should look for possible causes of challenging behaviour. These causes could include physical pain or relationships with people the person is living with, or being supported by.
She added that the nurses should also raise questions about whether drugs are making a difference and urge for regular reviews.
The nurses should pursue alternatives, such as positive behaviour support.
Lowest dose
She also cautioned that medication should be the lowest dose possible for the shortest time necessary.
However, she stressed that medical professionals should manage reductions carefully, as sudden withdrawal can be equally harmful.
A spokeswoman for the Royal College of General Practitioners stressed that autism is a “clinical priority” for the family doctors’ group. The group has appointed a dedicated “autism clinical champion”.
The spokeswoman said there was no-one available for comment on the over-medication issue.
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Published: 27 March 2017
