title: Factors Influencing the Use of Psychotropic Medication for Challenging Behaviour in the United Kingdom: A Q Method Investigation.
abstract: OBJECTIVE
  The use of pharmacological interventions to manage challenging behaviour displayed by adults with intellectual disabilities remains controversial, with current clinical guidelines in the United Kingdom advocating the use of less invasive psychological interventions. This exploratory study aimed to discover what views and beliefs are held by a sample of NHS professionals who provided care and treatment to adults with learning disabilities, about the factors that are influential in the clinical decision-making process, surrounding the prescription of psychotropic medication, to manage challenging behaviour.
  
  
  METHODS
  Q methodology was used to elucidate the factors considered influential in the clinical decision-making process, surrounding the prescription of medication to manage challenging behaviour. 55 participants from a range of services across the north-west of England performed a 104 statement Q-sort task.
  
  
  RESULTS
  Principle component factor analysis with varimax rotation was performed on the 55 completed Q sorts. This revealed a four factor solution, accounting for 44% of the variance in the data. The factors were interpreted and discussed under the following headings: 'High-quality safe ethical practice', Risk is a rationale for reactive prescribing', 'Pragmatic management' and 'Contextual issues'.
  
  
  CONCLUSIONS
  The study demonstrated that Q methodology is a useful tool for identifying subjective viewpoints held by a range of professionals, with regard to the factors that influence the clinical decision-making process surrounding the prescription of medication. The study suggests that services need to identify the wider contextual factors, which are barriers, to the use of less invasive psychological interventions.
authors: Five Boroughs NHS Trust, Prescot, UK.
authors: Sarah
authors: S
authors: Wastell
authors: Hutt Valley & Wairarapu District Health Boards, NZ.
authors: Paul
authors: P
authors: Skirrow
authors: University of Manchester, Manchester, UK.
authors: Dougal Julian
authors: DJ
authors: Hare
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000066553:Problem Behavior; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011779:Q-Sort; D006113:United Kingdom
chemical_list: D011619:Psychotropic Drugs
keywords: challenging behaviour; decision making; intellectual disabilities; medication