Development of an intervention to address overprescribing in people with intellectual disability

Project Description

Intellectual disability (ID) affects 1% of the population and is characterised by problems in intellectual and adaptive functioning. Compared with the general population, people with ID are more likely to have physical and mental health problems and are at risk of polypharmacy, particularly among older age groups. Polypharmacy increases the chances of being prescribed a medicine(s) with more risks than benefits, with adverse consequences to the persons quality of life. People with ID may not be able to verbally communicate their adverse experiences, and may also be at risk of diagnostic overshadowing.

Deprescribing is identifying and discontinuing medicines with more risks than benefits. There is a burgeoning body of literature evidencing that deprescribing is not routine practice owing to barriers including fear of adverse consequences, a perception that patients are attached to their medicines and it not being a priority.

This PhD programme of research will co-produce a theory and evidence-based intervention to support deprescribing for people with ID. The research will be underpinned by behaviour change theory, follow the Medical Research Council’s framework for intervention development, and is likely to comprise of three projects:

Project 1: A systematic review of healthcare professionals’ barriers and enablers to deprescribing for people with ID.

Project 2: A mixed methods study, with active involvement of adults with ID and their carers, to contextualise, fully understand and prioritise for addressing in an intervention, the barriers and enablers from Project 1.

Project 3: Co-production of an intervention that addresses the prioritised barriers and enablers.