“I would prefer to be prescribing less”: Perceptions on antipsychotics and challenging behaviour
Bibliographic record
Abstract
Aims: Challenging behaviour in individuals with intellectual disabilities affects quality of life and often results in antipsychotic use, despite guidelines recommending non-drug approaches as the first line. This study explores healthcare team perspectives on managing challenging behaviour, barriers to reducing antipsychotic overprescription, and possible solutions. Methods: A cross-sectional qualitative study using thematic analysis of an online team discussion and survey. Findings were used to develop a driver diagram of proposed strategies. Results: Three themes were identified: (1) varied views on current prescribing practices, with concerns about overuse and limited awareness of guidance; (2) key barriers including staffing shortages, reluctance to reduce medication, poor communication, lack of structured reviews, and absence of outcome measures; and (3) proposed solutions such as family involvement, regular reviews, improved outcome tracking, staff education, and clear care pathways. Conclusion: Addressing system-level barriers through coordinated team-based approaches may reduce reliance on antipsychotics and improve care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".