An interdisciplinary team approach to decision-making about the use of psychotropic medication for individuals with mental retardation

Abstract

The purpose of this study was to examine a decision-making model for developing psychotropic medication plans for individuals with mental retardation. The study examined relationships among medication knowledge, acceptance of the interdisciplinary team (IDT)-process, leadership, consensus, and the quality of the psychotropic medication plan. The study was conceptualized using Henderson's Model for Nursing. Henderson (1966) identified the nurse as an active participant on the IDT who helps plan and implement care designed to meet the needs of the individual. Two hundred eight (N = 208) team members from 49 interdisciplinary psychotropic medication review teams participated in the study. Teams from all four large regional Intermediate Care Facilities for the Mentally Retarded UCFs/MR) in one southeastern state participated. Multiple regression and hierarchical multiple regression analyses were performed to test the hypotheses. The first hypothesis, that consensus would be predicted by medication knowledge, acceptance of the IDT process, and leadership was partially supported. Leadership was a significant predictor of consensus. The second hypothesis, that the quality of the psychotropic medication plan would be predicted by medication knowledge, acceptance of the IDT process, and leadership was not supported. The third hypothesis, which added consensus to the model, did not explain any additional variance in the quality of the psychotropic medication plan. As part of this study, The Psychotropic Review for Interdisciplinary Decisions and Evaluation (PRIDE) scale was developed to assess the quality of psychotropic medication plans. Several threats to statistical conclusion validity were identified, which may have affected the results of the study. These included: small sample size, lack of independence of teams, low variability of responses to instruments, and multicollinearity. Psychotropic medication plans from some ICFs/MR were superior to those produced by others. Characteristics of the I CFs/MR, such as, the amount of guidance given to teams through written guidelines and policy, and the degree of administrative support reflected through availability of staff to participate in the review process, may have been the most significant factors influencing the quality of psychotropic medication plan produced.