Quality Improvement: psychotropic prescribing for patients with learning disabilities and or autism

Prescription drugs

18 January 2018

Thousands of adults with a learning disability and or autism are taking prescribed psychotropic drugs without appropriate clinical indications. This patient group suffers from health inequalities, with shorter life expectancy than the general population, and increased prevalence of diabetes, heart failure and chronic kidney disease. Psychotropic drugs exacerbate these inequalities due to side effects including weight gain, hypertension, increased cholesterol and tiredness. 

However, it is challenging to effectively manage the prescription of psychotropic medication for patients with a learning disability and or autism, to minimise potential negative impacts.To improve this management, the RCGP and Clinical Practice Research Datalink (CPRD) have  developed bespoke data reports to support practices. The reports, which were featured in a previous edition of Clinical News, have just been distributed to practices across all four nations of the UK.

The reports include two indicators:

  • Long-term prescription of anti-psychotics to patients with Learning Disabilities and/or Autism
  • Long-term prescription of anti-depressants to patients with Learning Disabilities and/or Autism

For each of these indicators, the reports:

  • Show how your practice’s prescription rate compares with peers across CPRD’s UK dataset
  • Allow you to re-identify patients whose treatment may need review 
  • Provide support material that summarises STOMP and NICE guidance, and gives links to useful online resources

These indicators are based on Public Health England’s Stopping Over-Medication of People with a Learning Disability, Autism or Both (STOMP) project, which aims to improve the quality of life of people with a learning disability, autism or both by reducing the potential harm of inappropriate psychotropic drugs.

These reports are part of the collaborative programme of Quality Improvement reports produced by RCGP and CPRD. Reports focusing on the heart and circulatory system are due to be distributed in the Spring of 2019, and will include prescribing indicators taken from the RCGP Patient Safety Toolkit.  

The reports are available to all practices that contribute data to CPRD in England, Wales, Scotland and Northern Ireland. Because the reports are based on the CPRD data extract, practices that are not already in the CPRD network will need to sign up by completing the application form on the CPRD website - please tick the ‘RCGP/quality improvement’ box under ‘How did you hear about us?’ on the joining form.

You can learn more about the Quality improvement: prescribing and patient safety reports from the RCGP or CPRD.  You can also get in touch by emailing the RCGP project lead, David Mullett

If you want to find out more about over-medication of patients with learning disabilities and or autism, there are resources on both the RCGP and the NHS England website. 

Follow us on Twitter: @RCGP, @CPRD


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