Anti-psychotic Drug Prescribing Patterns Within Specialist Adult ID Services in England and Wales

NCT ID: NCT06238089

Last Updated: 2024-02-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

600 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-12-19

Study Completion Date

2024-04-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The overall aim of this observational study is to establish the anti-psychotic prescribing patterns across specialist intellectual disability (ID) services in England and Wales by collecting cross-sectional retrospective data at 7 annual time-points (1st July) from 2017 to 2023.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Feasibility protocol objectives:

1. Is it feasible to identify People with Intellectual Disabilities (PwID) who have been prescribed 2 or more anti-psychotic medications over 7 years retrospectively.
2. It is possible to obtain a complete data set for each patient identified and therefore be able to explore the prescribing patterns across the eight sites.
3. Is it feasible to quantify anti-psychotic treatment (APT) prescribing in PwID as chlorpromazine equivalent dose values across different healthcare Trusts in England and Wales.

Main objectives:
4. To explore yearly and overall prescribing patterns among PwID (with or without mental-health reasons (psychiatric co-morbidities)) in receipt of ≥2 forms of anti-psychotic treatment (multiple) over time?
5. How has multiple anti-psychotic treatment prescribing changed between 2017 and 2023 using chlorpromazine equivalent dose values, in PwID with mental health and no mental health indications?
6. What has been the impact of the COVID-19 pandemic (and corresponding lockdown restrictions in England and Wales) on multiple anti-psychotic treatment prescribing among PwID?
7. Can the NHS England Statistical Process Control tool (SPC) be utilised to track yearly anti-psychotic treatment prescribing among PwID receiving multiple forms of anti-psychotic treatment, and monitor variation between services (sites) and patient groups (e.g. psychiatric co-morbidities; challenging behaviour).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Intellectual Disability

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Eligible patients who have had a psychiatric review by specialist adult ID services in 2017.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting intra-muscular (IM) injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2017.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2018.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2018.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2019.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2019.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2020.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2020.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2021.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2021.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2022.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2022.

No interventions assigned to this group

Eligible patients who have had a psychiatric review by specialist adult ID services in 2023.

Adults with an intellectual disability who are under the care of ID services in receipt of \>2 oral and/or long-acting IM injectable anti-psychotic treatments (depots), who have had a psychiatric review by specialist adult ID services in 2023.

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patient had psychiatric review by specialist adult ID services in the last year (e.g. for a patient to be included at 1st June 2017, data to be recorded from the most recent psychiatric review within the period between 1st January 2017 - 31st December 2017).
* Patient has a diagnosis of ID
* Patient under the care of specialist adult ID services
* Patient on \>2 anti-psychotic treatments (oral and IM injectable (depots))

Exclusion Criteria

* Patients treated with Clozapine
* Under the age of 18 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Plymouth

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Professor Rohit Shankar

Professor in Neuropsychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Professor Shankar

Role: PRINCIPAL_INVESTIGATOR

University of Plymouth

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Cheshire and Wirral Partnership NHS Foundation Trust

Chester, , United Kingdom

Site Status RECRUITING

Coventry and Warwickshire Partnership NHS Trust

Coventry, , United Kingdom

Site Status NOT_YET_RECRUITING

Hertfordshire Partnership University NHS Foundation Trust

Hatfield, , United Kingdom

Site Status NOT_YET_RECRUITING

Leicestershire Partnership NHS Trust

Leicester, , United Kingdom

Site Status RECRUITING

Central and North West London NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

North East London NHS Foundation Trust

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Cornwall Partnership NHS Foundation Trust

Redruth, , United Kingdom

Site Status NOT_YET_RECRUITING

Swansea Bay University Health Board

Swansea, , United Kingdom

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Professor Shankar

Role: CONTACT

+44 (0) 1752 439831

Emily Stanyard

Role: CONTACT

+44 (0) 1752 439831

References

Explore related publications, articles, or registry entries linked to this study.

Branford D, Shankar R. Antidepressant prescribing for adult people with an intellectual disability living in England. Br J Psychiatry. 2022 Aug;221(2):488-493. doi: 10.1192/bjp.2022.34.

Reference Type BACKGROUND
PMID: 35249557 (View on PubMed)

Howkins J, Hassiotis A, Bradley E, Levitas A, Sappok T, Sinai A, Thakur A, Shankar R. International clinician perspectives on pandemic-associated stress in supporting people with intellectual and developmental disabilities. BJPsych Open. 2022 Apr 18;8(3):e84. doi: 10.1192/bjo.2022.49.

Reference Type BACKGROUND
PMID: 35431024 (View on PubMed)

Tromans S, Kinney M, Chester V, Alexander R, Roy A, Sander JW, Dudson H, Shankar R. Priority concerns for people with intellectual and developmental disabilities during the COVID-19 pandemic. BJPsych Open. 2020 Oct 29;6(6):e128. doi: 10.1192/bjo.2020.122.

Reference Type BACKGROUND
PMID: 33118913 (View on PubMed)

Naqvi D, Perera B, Mitchell S, Sheehan R, Shankar R. COVID-19 pandemic impact on psychotropic prescribing for adults with intellectual disability: an observational study in English specialist community services. BJPsych Open. 2021 Dec 6;8(1):e7. doi: 10.1192/bjo.2021.1064.

Reference Type BACKGROUND
PMID: 34865678 (View on PubMed)

Leucht S, Samara M, Heres S, Davis JM. Dose Equivalents for Antipsychotic Drugs: The DDD Method. Schizophr Bull. 2016 Jul;42 Suppl 1(Suppl 1):S90-4. doi: 10.1093/schbul/sbv167.

Reference Type BACKGROUND
PMID: 27460622 (View on PubMed)

Patel MX, Arista IA, Taylor M, Barnes TR. How to compare doses of different antipsychotics: a systematic review of methods. Schizophr Res. 2013 Sep;149(1-3):141-8. doi: 10.1016/j.schres.2013.06.030. Epub 2013 Jul 8.

Reference Type BACKGROUND
PMID: 23845387 (View on PubMed)

Shankar R, Wilcock M, Deb S, Goodey R, Corson E, Pretorius C, Praed G, Pell A, Vujkovic D, Wilkinson E, Laugharne R, Axby S, Sheehan R, Alexander R. A structured programme to withdraw antipsychotics among adults with intellectual disabilities: The Cornwall experience. J Appl Res Intellect Disabil. 2019 Nov;32(6):1389-1400. doi: 10.1111/jar.12635. Epub 2019 Jun 13.

Reference Type BACKGROUND
PMID: 31192534 (View on PubMed)

Mehta H, Glover G. Psychotropic drugs and people with learning disabilities or autism, 2019. Public Health England.

Reference Type BACKGROUND

National Health Service. Stopping over medication of people with a learning disability, autism or both (STOMP). NHS England " Stopping over medication of people with a learning disability, autism or both (STOMP) [Accessed 15th December 2023).

Reference Type BACKGROUND

Taylor DM, Barnes TR and Young AH. The Maudsley prescribing guidelines in psychiatry. 13th ed. West Sussex: Wiley-Blackwell; 2018.

Reference Type BACKGROUND

National Health Service. Statistical process control tool. https://www.england.nhs.uk/statisticalprocess-control-tool/ [Accessed 15th December 2023].

Reference Type BACKGROUND

Stanyard E, Neilens H, Allgar V, Bailey M, Musicha C, Purandare K, Perera B, Roy A, Sawhney I, Watkins L, Jaydeokar S, Lennard S, Mitchell S, McGowan P, Laugharne R, Tromans SJ, Shankar R. A novel way to understand and communicate the burden of AntiPsycHotic prescribing for adults across specialist Intellectual Disability services in England and Wales: the APHID feasibility study protocol. Front Health Serv. 2025 May 9;5:1393805. doi: 10.3389/frhs.2025.1393805. eCollection 2025.

Reference Type DERIVED
PMID: 40416595 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

TRUST/VC/AC/SG/6328-9580

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

331470

Identifier Type: OTHER

Identifier Source: secondary_id

4548

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Study of Mental Care in Spain
NCT00824031 COMPLETED