Direct care staff knowledge about medication for individuals with intellectual disabilities
| Pages | 144-151 |
| Date | 12 June 2019 |
| Published date | 12 June 2019 |
| DOI | https://doi.org/10.1108/AMHID-01-2019-0002 |
| Author | Amanda Sawyer,Johanna Lake,Yona Lunsky |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Direct care staff knowledge about
medication for individuals with
intellectual disabilities
Amanda Sawyer, Johanna Lake and Yona Lunsky
Abstract
Purpose –The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple
medications, with psychotropic medications being the most commonly prescribed. Direct care staff play an
important role in psychotropic medication administration and monitoring, yet little is known about their
knowledge and comfort with medication. The paper aims to discuss this issue.
Design/methodology/approach –A 15-item survey, focusing on self-reported knowledge and comfort
with psychotropic medication, was completed by 152 direct care staff employed at three agencies providing
residential services for individuals with ID across Ontario.
Findings –In total, 62 per cent of staff respondents reported that psychotropicmedications were among the
top medications regularly taken by the individuals they support, with behaviour listed as the most commonly
reported reason for taking this medication. The majority of staff reported monitoringmedication, however, the
frequency of monitoring varied considerably. Generally, staff reported feeling comfortable and knowledgeable
about medication use, but, most reported a desire for additional medication training.
Originality/value –This is the first Canadian study to examine staff knowledge and comfort regarding
medicationuse, and the first study to assess PRN (“as needed”)as well as regularly administeredmedications.
Keywords Intellectual disability, Training, Medication, Comfort, Direct care staff, Medication knowledge
Paper type Research paper
The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple
medications, with psychotropic medications prescribed most often (Sheehan et al., 2015; Stortz
et al., 2014). Studies from different jurisdictions have identified that individuals living in group
home settings are more likely to be prescribed psychotropic medications compared to those
living in the family home (Kroese et al., 2013; Roberston et al., 2000; Lunsky et al., 2018). This is
concerning given high rates of psychotropic medication use in individuals with ID, particularly in
the absence of other non-pharmacological interventions (i.e. behaviour therapy, counseling,
psychoeducation), which have potentially fewer adverse effects (Lunsky et al., 2018).
For individuals with ID, the diagnosis and treatment of mental health issues and challenging
behaviour, including medication administration, often involves caregivers (e.g. paid or unpaid).
In grouphome settings, the caregivingrole is typically carriedout by direct care staff, andnot health
care providers. These staff often play an important role in communicating the individual’s
symptoms and behaviours to aid in the diagnosis of mental health issues(Costello et al.,2007),as
well as communicatingthe effects of medication (Christian et al., 1999). Staff input may also guide
the prescribingphysician’s choice of medicationand medication adjustments (Kroeseet al.,2013,
Heslop et al., 2005). Despite this responsibility, direct care staff often receive inconsistent or
inadequate training regarding medication and mental health issues (Fretwell and Felce, 2007;
Woodward and Halls,2009). In the UK and elsewhere, a numberof guidelines have been put in to
place to promote thesafe and effective use of medicationfor individuals with ID (Deb et al.,2009;
NHS England, 2016; NICE, 2015 guidelines; Sheehan and Hassiotis 2016; Sullivan et al.,2011;
The Royal College of Psychiatrists, 2016), and in 2011 in Ontario, Canada, regulations were
Received 18 January 2019
Revised 15 February 2019
Accepted 25 February 2019
Amanda Sawyer,Johanna Lake
and Yona Lunsky areall
based at Azrieli Adult
Neurodevelopmental Centre,
Centre for Addiction and Mental
Health, Toronto, Canada.
PAGE144
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 13 NO. 3/4 2019, pp.144-151, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-01-2019-0002
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