Building quality indicators for medication use in people aging with intellectual disabilities and behaviour disorders

Objectives: The quality of healthcare provided to people with intellectual disabilities, is under scrutiny. The aim of this project was to build quality indicators (QIs) that could be used to measure the quality of the medication use process for people with intellectual disabilities and behaviour disorders.Methods: Candidate Qls were developed using literature and guideline review and expert evaluation. The candidate Qls were submitted to a 32-member panel of multidisciplinary experts, from Ireland and the UK. The modified Delphi panel included psychiatrists, pharmacists, nursing personnel, speech and language therapists, geriatricians, psychologists and representation from academia, regulation and administration. Over 2 rounds the QIs were rated for importance, scientific soundness and feasibility on a 9 point likert scale. Consensus criteria were preset.Results: A total of 38 candidate QIs underwent Delphi scoring. QIs addressed patient experience, access to care, continuity of care, equity, patient safety, effectiveness, appropriateness and assessment. Following round one, 23 QIs were accepted, none were rejected and 15 were equivocal. A total of 30 candidate QIs were accepted following round 2. Selection criteria were raised to differentiate hierarchy of final list.Conclusions: This project was the first attempt to develop QIs for the medication use process in people with intellectual disabilities and behaviour disorders. They infer a judgement about the quality of care provided in the medication use process. They may become important definitions of quality care for people with intellectual disabilities and behaviour disorders and be useful for quality improvement in this vulnerable population.