GPs urged to review prescribing for patients with learning disabilities or autism

GPs have been urged to review prescribing for patients with learning disabilities or autism, after the RCGP signed a pledge committing to reduce inappropriate medication for these groups.

The college was one of six organisations to sign the Stopping Over-Medication of People with a Learning Disability (STOMPLD) pledge this week.

NHS England said thousands of adults with learning disabilities had been given prescriptions for an antipsychotic, an antidepressant or both without appropriate clinical justification. Side effects of long-term use of these drugs can include significant weight gain, organ failure and even death.

A toolkit was launched by the RCGP with NHS England to encourage family doctors and their teams to review prescriptions of people on their patient list, and to ensure psychotropic drugs are only continued where the person poses a severe risk to the safety of themselves and others, and all other alternatives have been exhausted.

Find out more about STOMPLD at the RCGP Annual Conference

RCGP clinical innovation and research centre medical director Dr Matt Hoghton said: 'Working collaboratively between healthcare professionals and carers is really important in tackling the appropriate use of psychotropic drugs in our patients with learning disabilities, and signing this pledge today is an important commitment to ensuring they receive the best possible care.

'While GPs rarely initiate these medications, they have a key role to play in reviewing and ensuring our patients with learning disabilities are only taking drugs if they need to, and that their records indicate why they are taking them, so this guidance is welcome.'

GP prescribing advice

The GPC supported the moves but said family doctors needed to act with caution.

'I would encourage GPs to look afresh at their patients, but withdrawing medication is not to be taken lightly and should be done after discussions with carers and the patient, alongside a capacity assessment,' said GPC prescribing subcommittee chairman Dr Andrew Green.

'Support should be in place for any resulting difficulties, and many GPs will feel that their patients will best be served by a referral back into secondary care for this to be done.'

NHS England national medical director Sir Bruce Keogh said reducing use of powerful drugs was a positive ambition.

'We have managed this successfully in dementia; it’s now time to bring similar benefits to patients who have a learning disability,' he said.

The other bodies to sign the pledge were the Royal College of Nursing, the Royal College of Psychiatrists, the Royal Pharmaceutical Society, the British Psychological Society and NHS England.

A special session (C3) at the RCGP Annual Conference will provide GPs with the knowledge and resources to review prescribing of psychotropic drugs in this group of patients.

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