The Effect of SPECTROM Training on Support Staff Knowledge of Psychotropic Medicine and Attitude Towards Behaviours That Challenge in Adults With Intellectual Disabilities to Help Implement the STOMP Initiative.

Abstract

Background: Overmedication of adults with intellectual (learning) disabilities, particularly the off-licence use of psychotropic medicines for behaviours that challenge in the absence of a psychiatric disorder, is a major public health concern and an example of health inequalities. In the United Kingdom, we coproduced online training resources backed up by face-to-face training for support staff (direct care workers) called SPECTROM involving all stakeholders, including adults with intellectual disabilities and their families, to help reduce the overmedication and implement NHS England's STOMP initiative.

Method: In a feasibility cluster randomised controlled trial, we trained service managers and support staff using two core modules of SPECTROM, namely, (a) Medicine/STOMP and (b) Alternatives to Medicine (ATM) using an online platform. These two core modules introduced 12 other modules and other online resources. We assessed trainees' knowledge of psychotropic medicines using the Psychotropic Knowledge Questionnaire-Revised (PKQ-R) and their attitude to behaviours that challenge using the Management of Aggression and Violence Attitude Scale-Revised-Intellectual Disabilities (MAVAS-R-ID) using a pre-post training design.

Results: The research team delivered SPECTROM training to 18 service managers and 122 support staff. Of the 140 trainees, 126 completed PKQ-R at baseline before and within 4 weeks after the training. There was a post-training improvement in PKQ-R scores in 42 of the 43 questions (97.7%), 22 of which were statistically significant differences (p < 0.001). The MAVAS-R-ID was completed at baseline and within 4 weeks of training by 125 trainees. The MAVAS-R-ID total score showed statistically significant post-training improvements (p < 0.01). Individual domain score analysis showed a statistically significant improvement in one of the five domains related to attitude regarding the use of medicine for behaviours that challenge.

Conclusions: The SPECTROM training seems to improve staff knowledge of psychotropic medicine, at least in the short-term, and attitude towards behaviours that challenge, particularly concerning the use of psychotropic medicine.