GGZ-Drenthe/Centre for ID and Mental Health, 9404 LL Assen, The Netherlands.
Academic Collaboration ID and Mental Health, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands.
Int J Environ Res Public Health. 2022 Nov 24;19(23):15637. doi: 10.3390/ijerph192315637.
People with intellectual disabilities (PwID) are frequently prescribed long-term antipsychotics for behaviours that challenge (BtC) despite the lack of proven effectiveness and the increased risks for side effects of these medications in this population. National and international good clinical practice guidelines recommend deprescribing antipsychotics for BtC, which is often not successful due to environmental and other factors. The involvement of all stakeholders, including PwID, is crucial for deprescribing. However, studies showed that PwID and/or their families are often not involved in decision-making regarding the (de)prescribing of antipsychotics despite their desire to get involved. Moreover, studies on the views of PwID regarding their experiences of withdrawing from antipsychotics are lacking. The aim of this study was to gain insight into the views of PwID by investigating their experiences of discontinuation of long-term prescribed antipsychotics for BtC. A qualitative study was set up. Seven experts by experience with mild intellectual disabilities were interviewed. After six interviews, data saturation was achieved. Interviews were transcribed verbatim. Using phenomenological analysis, themes on lived experiences were extracted. Each consecutive interview was analysed. The four main themes extracted from the interviews were the quality of treatment, knowledge and information about psychotropics and the process of withdrawal, support from the participants' environment and the coping style of the interviewees themselves.
智障人士(PwID)经常因行为挑战(BtC)而被长期开处抗精神病药物,尽管这些药物在该人群中的疗效缺乏证据支持,且副作用风险增加。国家和国际良好临床实践指南建议减少 BtC 抗精神病药物的处方,但由于环境和其他因素,这通常无法成功。包括 PwID 在内的所有利益相关者的参与对于减少处方至关重要。然而,研究表明,尽管智障人士及其家属希望参与,但他们在决定(减少)抗精神病药物的处方时往往不被包括在内。此外,关于智障人士对停药体验的看法的研究也很少。本研究旨在通过调查他们因 BtC 而长期服用的抗精神病药物停药的经历,深入了解智障人士的观点。本研究采用定性研究方法。对 7 名轻度智力障碍的经验丰富的专家进行了访谈。在进行了 6 次访谈后,达到了数据饱和。访谈内容逐字转录。采用现象学分析,提取了关于生活体验的主题。对每一次连续的访谈进行分析。从访谈中提取的四个主要主题是治疗质量、关于精神药物的知识和信息以及停药过程、参与者环境的支持以及受访者自身的应对方式。