Psychiatrists and non-psychiatrists’ attitudes to psychotropic optimisation for people with intellectual disabilities and/or autism:A cross-sectional comparison study

<b>Background: </b><br/>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. <br/><br/><b>Aim: </b><br/>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. <br/><br/><b>Methods: </b><br/>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-square, Mann-Whitney and unpaired t-tests with significance taken as p&lt;0.05. Thematic analysis of free-text responses was undertaken using Braun and Clarke’s methodology was undertaken<br/><br/><b>Results: </b><br/>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 over- 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/training and alternatives/structure)<br/><br/><b>Conclusions: </b><br/>This is the first study to highlight important differences exist between psychiatrists and non-psychiatrists’ attitudes to psychotropic optimisation in spite of respondents overall being broadly supportive of it’s need. A major finding also is the hitherto unquantified concerns of patient ethnicity and its impact on psychotropic optimisation principles. <br/>