Adherence to STOMP principles in CAMHS learning disability services: a clinical audit of prescribing, monitoring, and multidisciplinary practice
B. T. Kece, K. PowellIntroduction
Psychotropic over-prescription in people with learning disability remains a global concern. STOMP promotes lowest-effective-dose prescribing, psychosocial support, and regular review. We audited two CAMHS LD services (Hereford and Worcester) against STOMP standards.
Objectives
To compare: (1) documentation of indication and reduce/stop plans; (2) specialist initiation; (3) MDT involvement at initiation and review; (4) review frequency; (5) antipsychotic monitoring; (6) behavioural/psych support; and (7) capacity/best-interests documentation.
Methods
Retrospective case-note review using a standard pro-forma. Hereford: 20 young people (8-17y) and Worcester: 12 young people (8-17y) with moderate-severe LD with or without autism on psychotropics were randomly selected. Data was collected on: specialist initiation, reduce/stop plan, MDT input, review interval, behavioural plan, capacity/best-interests and rationale documentation along baseline/ongoing monitoring.
Results
Prescribing was specialist-initiated with rationale documented in both counties (Hereford, 90%; Worcester, 100%). Reduce/stop plans were rare (Hereford, 10%; Worcester, 17%). MDT involvement at initiation was limited in Hereford (30%) but registered more in Worcester (67%). Ongoing MDT reviews were absent in both counties. Antipsychotic use was higher in Hereford (70%) than Worcester (50%). Monitoring was complete for most in Hereford (79%) and Worcester (83%). Capacity/best-interest documentation in Worcester was fully consistent (100%) but lower in Hereford (60%). Review intervals aligned with guidance.
Comparative findings Table 1. Long description.