Training support workers about the overmedication of people with intellectual disabilities: an Australian pre–post pilot study

Abstract

Background There is evidence that psychotropic medications are overprescribed and overused to manage behaviours of concern for people with intellectual disabilities. Disability support workers and support staff lack education and training on the administration and safety of psychotropic medication use. This study aimed to test the applicability and preliminary efficacy of SPECTROM, an education programme developed in the UK, in an Australian context. MethodsThe training comprises two parts: Module 1 encompasses psychotropic medications, their use and side effects. Module 2 focuses on non-pharmacological interventions for supporting people with behaviours of concern. Thirty-three participants attended the training course and completed pre-training and post-training surveys on the Psychotropic Knowledge Questionnaire and Management of Aggression and Violence Attitude Scale-Revised at four time points: pre-training, 2 weeks, 3 months and 5 months post-training. Results Psychotropic Knowledge Questionnaire scores showed statistically significant post-training improvement at all post-training time points (P < 0.05). Management of Aggression and Violence Attitude Scale-Revised scores were high at pre-training and did not change significantly at any of the post-training survey time points. A 2-week posttraining feedback questionnaire reported 80% agreement that the training programme was appropriate, useful and valid. Only 36% of participants completed questionnaires at all time points. Conclusions SPECTROM training increased staff knowledge of psychotropic medications, yet loss of participants was high. Further refinement of the applicability of the training for the Australian context and evaluation of the feasibility of implementation, clinical and cost-effectiveness of the programme are required.

The UK psychiatrists' experience of rationalising antipsychotics in adults with intellectual disabilities: A qualitative data analysis of free‐text questionnaire responses

“…To address the issue of caregiver training, we have recently developed an online training resource backed up by face-toface workshops (SPECTROM; https://spectrom.wixsite.com/project) to help rationalise antipsychotics and other psychotropic medications (Deb et al, 2020). Two small pre, and post-intervention pilot studies of SPECTROM training in the United Kingdom (Deb et al, 2021) and Australia (Barratt et al, 2023;Wilson et al, 2022Wilson et al, , 2023 have received good feedback from the trainees and the trainers on the acceptability, practicality, applicability and relevance of SPECTROM to their practice and helped to empower support staff by increasing their knowledge of psychotropic medication and improving attitude toward using medication for challenging behaviour. Some participants in the current study found input from local pharmacists and nurse prescribers helpful in implementing STOMP.…”

Staff perceptions following a training programme about reducing psychotropic medication use in adults with intellectual disability: The need for a realistic professional practice framework

“…This paper solely presents rich qualitative data from post‐intervention interviews. Outcomes data is presented in a separate paper (Wilson et al, 2023). As this aspect of the study was exploratory in nature, a qualitative research design using individual interviews was utilised (Beail & Williams, 2014).…”

Training Direct Care Staff to Empower Adults with Intellectual Disabilities and Their Families to Reduce Overmedication

“…Forty-two participants received SPECTROM training in a recent Australian pre-post pilot study (Wilson et al, 2023). PKQ-R scores showed statistically significant post-training improvement at all post-training time points (p < 0.05).…”