Teaching GPs about depression and suicide can help reduce the risk of suicide in depressed older adults, says new RCT


A great deal of time and money has been spent on improving the diagnosis and management of depression and self-harm in primary care. The evidence tells us that collaborative care and case management can be effective approaches, which is all well and good, but these complex interventions are not always feasible. This new cluster randomised [read the full story…]

Physical interventions governance audit identifies value of multi disciplinary overview


The use of physical interventions for people with learning disabilities must be within a locally agreed policy framework and as a last resort. Commissioners of services need to be assured that their use is appropriate and that good quality monitoring is taking place. The researchers in this study looked at the work of good practice [read the full story…]

Antipsychotics continue to be used for challenging behaviour in learning disabilities with poor monitoring of side effects


People with learning disabilities are often prescribed anti-psychotic medication, whether or not there has been a diagnosis of psychiatric disorder. There continues to be some concern about the evidence base to support this. The most recent Cochrane review which looked at the issue in relation to people with learning disabilities and schizophrenia found that there is [read the full story…]

Use of behaviour consultants reduced restrictive intervention in people learning disability and challenging behaviour


Behaviour support plans to guide the way supporters respond and react to people with learning disabilities who are described as having behaviour that challenges are fundamental to the quality of support they receive. The authors of this Australian study were interested in looking at the quality of the plans and their effectiveness in providing support. [read the full story…]

Significant improvements needed to care for people with dementia in hospital, says national clinical audit


The first full report of the National Audit of Dementia has identified a need for significant improvements in hospital ward environments, staff training and the overall approach to care delivery for patients with dementia. Although the majority of wards meet basic safety requirements, the audit shows that many had not addressed simple measures that could [read the full story…]

Psychological therapy services demonstrate benefits for patients but further improvement is needed

This meta-analysis included 29 RCTs, representing 10,430 patients from 11 countries, and reported a 43% reduction in anxiety from primarily CBT-based psychotherapies.

A report into the care received by patients with anxiety and depression across more than 350 NHS-funded psychological therapy services in England and Wales has revealed good overall standards of care, but substantial variation in quality. The National Audit of Psychological Therapies (NAPT), commissioned by the Healthcare Quality Improvement Partnership (HQIP) and carried out by [read the full story…]

Staff training on pain improves use of communication and assessment tools


In 2009, researchers in Surrey completed an audit of pain recognition and management within the learning disability services there. One of the key recommendations from that audit was that staff in learning disability services should receive training in pain recognition and management. As a result, nearly 200 services in the locality (from an invitation list [read the full story…]

Patients with learning disabilities visiting psychiatric ED may be sent home with no recorded follow up plans


Researchers in this Canadian study looked at the factors associated with the use of psychiatric emergency services by people with learning disabilities who were living with their family. They conducted an audit of hospital chart audits for a sample of 20 such individuals with learning disabilities who had visited the emergency department (ED) at the [read the full story…]

Use of simple visual prompt improves recording of capacity to consent assessments


This study set out to examine the practice of a number of psychiatrists working in a large learning disability service in relation to their recording capacity to consent to treatment and discussions with patients about side effects of medication. A number of measures were introduced to improve practice in the service including the application of [read the full story…]

Audit of antipsychotic prescribing shows good efficacy reviewing but poor monitoring of side effects

medicine in blisterpack

Antipsychotics are widely used for the management of behavioural problems in people with learning disability, despite concerns about the lack of a good evidence base for this practice (see Cochrane review) The researchers in this study set out to audit clinical practice of prescribing anti-psychotics against standards of good practice. The authors collected data from [read the full story…]