Exploring barriers and facilitators in the implementation and use of guideline recommendations on antipsychotic drug prescriptions for people with intellectual disability

J Appl Res Intellect Disabil. 2018 Nov;31(6):1062-1070. doi: 10.1111/jar.12461. Epub 2018 Jun 20.

Abstract

Background: It is unknown why professionals' adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations.

Methods: In-depth interviews with four intellectual disability physicians, two psychiatrists and five behavioural scientists were used to explore the implementation and use of guideline recommendations.

Results: Barriers in adhering to recommendations were lack of collaboration of different disciplines involved in the treatment of psychiatric and behavioural disorders and lack of enforcement of an appropriate monitoring of side- and treatment effects. When guideline recommendations were translated into organizational policies, clinicians were able to divide responsibilities and tasks, needed to appropriately implement guideline recommendations in daily clinical practice.

Conclusions: To facilitate the use of guideline recommendations, organizations should translate recommendations into organization-specific policies, involving physicians and behavioural scientists in this process, while simultaneously creating more practical and technological support.

Keywords: adherence; antipsychotic drugs; guideline recommendation; implementation; intellectual disability care.

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Drug Prescriptions / standards*
  • Guideline Adherence / standards*
  • Health Personnel / standards*
  • Humans
  • Intellectual Disability / drug therapy*
  • Netherlands
  • Practice Guidelines as Topic / standards*
  • Qualitative Research

Substances

  • Antipsychotic Agents