Psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation for people with intellectual disabilities and/or autism: cross-sectional comparison study
Tromans, Samuel J Deb, Shoumitro Mahmood, Hassan Triantafyllopoulou, Paraskevi Jamieson, Tony Gookey, Gill Bassett, Paul Malak, Zayed sawhney, indermeet Korb, Laura
Tromans, Samuel J
Deb, Shoumitro
Mahmood, Hassan
Triantafyllopoulou, Paraskevi
Jamieson, Tony
Gookey, Gill
Bassett, Paul
Malak, Zayed
sawhney, indermeet
Korb, Laura
Affiliation
University of Leicester; Leicestershire Partnership NHS Trust; Imperial College London; Coventry and Warwickshire Partnership Trust; Tizard Centre, University of Kent; NHS England, Nottingham; Health Innovation East Midlands; Hertfordshire Partnership University NHS Foundation Trust; Barnet, Enfield and Haringey Mental Health NHS Trust; University of Warwick; King's College London; University of Plymouth; Cornwall Partnership NHS Foundation Trust
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Publication date
2025-10
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Abstract
Background: Off-licence psychotropic use in people with intellectual disability and/or autism, in the absence of psychiatric illness, is a major public health concern in England.
Aims: To ascertain and compare views of psychiatrists and non-psychiatrists working with people with intellectual disability and/or autism on psychotropic medication optimisation for this population.
Method: A cross-sectional survey of 13 questions was disseminated online among psychiatrists and other health professionals working with people with intellectual disability and/or autism across England, using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The questionnaire covered demographic characteristics, perceived barriers/benefits of psychotropic optimisation (including ethnicity) and views on implementation of a national medicine optimisation programme. Quantitative analysis used chi-squared, Mann-Whitney and unpaired t-tests, with significance taken as P < 0.05. Thematic analysis of free-text responses was undertaken with Braun and Clarke's methodology.
Results: Of 219 respondents, significant differences in attitudes to most issues emerged between psychiatrists (n = 66) and non-psychiatrists (n = 149). Psychiatrists had less optimism of a successful national medication optimisation programme if commissioned, or achieving 50% reduction in psychotropic overprescribing and inappropriate psychotropic prescribing generally. Perceived barriers to reducing overmedication differed significantly between the psychiatrists and non-psychiatrists, Thematic analysis identified five themes (system issues, resources, medication challenges, family and carers, and training and alternatives/structure).
Conclusions: This is the first study to highlight important differences between psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation despite respondents overall being broadly supportive of its need. A major finding is the hitherto unquantified concerns of patient ethnicity and its impact on psychotropic optimisation principles.
Citation
Tromans SJ, Deb S, Mahmood H, Triantafyllopoulou P, Jamieson T, Gookey G, Bassett P, Malak Z, Sawhney I, Korb L, Adams D, Sheehan R, Shankar R. Psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation for people with intellectual disabilities and/or autism: cross-sectional comparison study. BJPsych Open. 2025 Oct 23;11(6):e249. doi: 10.1192/bjo.2025.10875. PMID: 41128677.
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Article