APPRAISE
Structured multi stakeholder medicine optimisation planning to reduce inappropriate overmedication of antipsychotic medicines in adults with intellectual (learning) disabilities
About APPRAISE
APPRAISE is a randomised controlled trial that will assess whether structured multi-stakeholder antipsychotic medicine optimisation planning, supported by SPECTROM training, helps reduce antipsychotic medicine use and is good value for money for the NHS and social care services.
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Aims:
1.To evaluate the clinical and cost effectiveness of SPECTROM training combined with treatment as usual (TAU), compared with TAU alone. This includes assessing reductions in antipsychotic prescribing, changes in behavioural outcomes, quality of life, and economic implications for health and social care services.
2. To explore implementation processes and contextual factors that influence the delivery, uptake, and sustainability of the training. Understanding these factors will support future scaling and integration of SPECTROM into routine practice.
What does multi stakeholder medicine optimisation planning include?
A multi-stakeholder medicine optimisation planning is essentially a preparatory in-house medicine review led by a pharmacist and service manager using SPECTROM tools. In this review, data will be gathered to identify whether any residents will be suitable for medicine optimisation.
If a medicine reduction/ withdrawal is appropriate, then the pharmacist and service manager will liaise with the psychiatrist/GP (prescriber). The prescriber will ultimately decide whether any medicine is appropriate to reduce/ withdraw or not.
A deprescribing plan is then agreed and formulated with all stakeholders such as adults with intellectual disabilities, family carers, a member of the multi-disciplinary team (MDT), service managers, etc.
A contingency plan is also developed together.
The pharmacist and service managers will implement the plan and continue providing ongoing support. Pharmacists, managers, prescribers and MDT will monitor and review regularly for 18 months.