{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:23:34Z","timestamp":1767651814768},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,3,11]],"date-time":"2016-03-11T00:00:00Z","timestamp":1457654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001262","name":"Baily Thomas Charitable Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001262","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Research Intellect Disabil"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>, people with intellectual disabilities who exhibit aggressive behaviour often receive community\u2010based specialist health services from a community learning disability team (<jats:styled-content style=\"fixed-case\">CLDT<\/jats:styled-content>). Our aim was to estimate costs associated with this provision and to identify predictors of higher costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Costs were estimated for 60 adults with intellectual disabilities and aggressive behaviour who attended specialist psychiatric outpatient clinics in the West Midlands region of the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>, including contact time with members of the <jats:styled-content style=\"fixed-case\">CLDT<\/jats:styled-content> and use of psychotropic medication over a 12\u2010month period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean total cost of 12\u2010month service provision was \u00a3418 (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] \u00a3299\u2013557). Mean total cost of 12\u2010month psychotropic medication was \u00a3369 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u00a3256\u2013492). Amongst individual members of the <jats:styled-content style=\"fixed-case\">CLDT<\/jats:styled-content>, mean costs were highest for psychiatrists (\u00a3181) and relatively lower for community nurses (\u00a370) and clinical psychologists (\u00a330), and lowest for physiotherapists (\u00a313). Male sex, presence of expressive verbal communication and presence of epilepsy were independently associated with 12\u2010month medication and service use costs, accounting for 23% of the variance in cost.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It seems that in terms of costs, there is an overreliance on medication and psychiatrists and a relatively lesser reliance on other <jats:styled-content style=\"fixed-case\">CLDT<\/jats:styled-content> members such as community nurses and clinical psychologists for the management of aggressive behaviour in adults with intellectual disabilities within community settings. Health commissioners may wish to explore this relative cost discrepancy further and try to redress the balance where appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jar.12241","type":"journal-article","created":{"date-parts":[[2016,3,12]],"date-time":"2016-03-12T19:59:40Z","timestamp":1457812780000},"page":"316-325","source":"Crossref","is-referenced-by-count":6,"title":["An Exploration of Costs of Community\u2010Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities"],"prefix":"10.1111","volume":"30","author":[{"given":"Gemma","family":"Unwin","sequence":"first","affiliation":[{"name":"School of Psychology University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoumitro","family":"Deb","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Department of Medicine Centre for Mental Health Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Deb","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry Psychology and Neuroscience London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,11]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Challenging Behaviour: A Unified Approach (Clinical and Service Guidelines for Supporting People With Learning Disabilities who are at Risk of Receiving Abusive or Restrictive Practices)","author":"Banks R.","year":"2007"},{"key":"e_1_2_8_3_1","first-page":"200","volume-title":"Measuring Health Needs","author":"Beecham J.","year":"2001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780199659043.003.0017"},{"key":"e_1_2_8_5_1","volume-title":"SPSS for Psychologists: A Guide to Data Analysis Using SPSS for Windows","author":"Brace N.","year":"2000"},{"key":"e_1_2_8_6_1","volume-title":"British National Formulary 60 (September)","author":"British Medical Association and Royal Pharmaceutical Society of Great Britain","year":"2012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2004.00580.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2006.00815.x"},{"key":"e_1_2_8_9_1","volume-title":"Pay and Prices Index. 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