The management of psychotropic medications within residential facilities for the mentally retarded: An evaluation of research trends and applied strategies
The benefit of systematic approaches to psychotropic drug utilization in residential facilities for persons with mental retardation was investigated. This investigative process included a review of published attempts to implement systematic management procedures. To assess the impact of systematic approaches to psychotropic drug management, a model program was also implemented. A total of 187 persons residing at a residential facility for persons with mental retardation served as subjects. Cognitive deficits ranged from Profound mental retardation to Borderline intellectual abilities. The impact of the model program upon neuroleptic drug prevalence, the mean daily dosage of neuroleptic drugs, and the prevalence of polypharmacy was assessed by means of a pre- and post-implementation comparison. A McNemar change test indicated a significant reduction in the prevalence of neuroleptic drug use following the implementation of the management procedure. A correlated-pairs t-test indicated a significant reduction in the mean daily dosage of neuroleptic drugs among persons for whom those drugs were prescribed. A 95% reduction in polypharmacy was also achieved. Comparisons between groups with differing levels of mental retardation, as well as groups with and without secondary diagnoses of mental illness, were also conducted. Issues relating to diagnostic and drug treatment practices at residential facilities for persons with mental retardation are presented.