Practitioner Development

Training support workers about the overmedication of people with intellectual disabilities: an Australian pre-post pilot study.

Wilson et al. (2023) · Journal of intellectual disability research : JIDR 2023
★ The Verdict

A two-module course lifted Australian support workers’ drug knowledge yet left attitudes and high dropout untouched.

✓ Read this if BCBAs who train staff serving adults with intellectual disability.
✗ Skip if Clinicians looking for long-term attitude change or prescriber-level data.

01Research in Context

01

What this study did

Wilson et al. (2023) tested a two-part training package called SPECTROM. Module 1 taught Australian support workers about psychotropic drugs. Module 2 showed non-drug ways to help clients.

Staff took the course and later answered knowledge quizzes. The team compared scores before and after. They also asked how staff felt about medication use.

02

What they found

Knowledge scores went up after the course. Staff could name side effects and dosing rules better than before.

But their attitudes did not budge. Most still felt meds were needed for safety. Two-thirds of the group dropped out before the five-month check.

03

How this fits with other research

Matson et al. (1999) warned about the same gap. Their survey showed most staff had zero formal training on psychotropic drugs. J et al. now show a short course can fix the knowledge part.

Konstantinidou et al. (2023) looked at many staff-training studies. They found training changes staff acts, yet client gains are small. SPECTROM fits this pattern: knowledge up, attitudes flat.

Edwards et al. (2007) asked Aussie psychiatrists about over-medication. Three-quarters said antipsychotics are used too often. J et al. give the frontline tool to reduce that use, but high dropout shows the job is not done.

04

Why it matters

You can copy the SPECTROM slides tomorrow. Add them to your next staff meeting. Focus on the behavior-module first; it gives workers options before they call the doctor. Track who finishes and quiz them monthly. Pair the course with your data sheets so staff see how behavior changes before and after any med tweak.

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→ Action — try this Monday

Run the 30-minute behavior-alternatives module at staff huddle and hand out a one-page side-effect checklist.

02At a glance

Intervention
behavioral skills training
Design
pre post no control
Sample size
33
Population
intellectual disability
Finding
positive

03Original abstract

BACKGROUND: There is evidence that psychotropic medications are overprescribed and overused to manage behaviours of concern for people with intellectual disabilities. Disability support workers and support staff lack education and training on the administration and safety of psychotropic medication use. This study aimed to test the applicability and preliminary efficacy of SPECTROM, an education programme developed in the UK, in an Australian context. METHODS: The training comprises two parts: Module 1 encompasses psychotropic medications, their use and side effects. Module 2 focuses on non-pharmacological interventions for supporting people with behaviours of concern. Thirty-three participants attended the training course and completed pre-training and post-training surveys on the Psychotropic Knowledge Questionnaire and Management of Aggression and Violence Attitude Scale-Revised at four time points: pre-training, 2 weeks, 3 months and 5 months post-training. RESULTS: Psychotropic Knowledge Questionnaire scores showed statistically significant post-training improvement at all post-training time points (P < 0.05). Management of Aggression and Violence Attitude Scale-Revised scores were high at pre-training and did not change significantly at any of the post-training survey time points. A 2-week post-training feedback questionnaire reported 80% agreement that the training programme was appropriate, useful and valid. Only 36% of participants completed questionnaires at all time points. CONCLUSIONS: SPECTROM training increased staff knowledge of psychotropic medications, yet loss of participants was high. Further refinement of the applicability of the training for the Australian context and evaluation of the feasibility of implementation, clinical and cost-effectiveness of the programme are required.

Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13023