Achievement Awards Spotlight: UPMC Western Psychiatric Hospital

July 28, 2023

HAP's annual Achievement Awards honor hospitals and health systems for their innovation, creativity, and commitment to patient care. The Achievement Awards showcase and share member hospitals’ and health systems’ successful programs and best practices.

This year, UPMC Western Psychiatric Hospital received the Excellence in Care award for its outstanding project to safely taper or reduce the use of psychotropic medications for patients with autism spectrum disorder (ASD) or intellectual disability (ID).

Here’s what you need to know:

• Background:  Adults with ASD or ID often have co-occurring psychiatric disorders that involve the prescription of certain psychotropic medications, but medication management guidelines in these population groups are limited.
  • Guidelines encourage deprescribing whenever possible, but a lack of guidance about how and when to deprescribe can make it challenging to do so.
• Taking action:  When patients on scheduled benzodiazepines were stable for several months, the clinical team worked closely with patients, caregivers, and other providers to develop a tailor-made taper plan.
  • Taper responses were documented in the electronic health record through assessments by clinic psychiatrists, the clinic nurse, and a clinical pharmacist.
• Results:  Initial analysis indicated the study group was able to successfully taper benzodiazepines in patients with ASD and/or ID without worsening of psychiatric stability or requiring additional psychotropic medications.
  • A subset of patients completely discontinued their scheduled benzodiazepine while others have significantly reduced their dose while continuing to work towards discontinuation.
• Core emphasis:  Discussions of benzodiazepine tapers should be included within the routine medication management process and at regular intervals upon patients achieving symptom stability, the team noted in its entry. 
• Quotable:  “When seeing patients with ID and/or ASD with problematic behaviors, it is important to routinely emphasize that the goals of care are to continue to use medications at the lowest doses for the shortest duration possible,” the team noted in its entry.

“The idea of tapering medications during periods of stability was a new idea to many caregivers and patients, and a good deal of psychoeducation was given to get buy-in to taper medications,” the team noted. “This is something that, should other systems want to do a similar project, should be discussed routinely during evaluations.”

Congratulations to UPMC Western Psychiatric Hospital for its dedication to improving care for people with autism spectrum disorder and intellectual disability.

Questions about the HAP Achievement Awards may be directed to HAP Member Services at (717) 561-5359.