Pragmatic Reasonable Accommodation in Everyday Medicine for People with Intellectual Disabilities: A Qualitative Study of Non-Psychiatric Physicians in Japan.

BACKGROUND:In Japan, providing reasonable accommodation for people with intellectual disabilities became mandatory on 1 April 2024, but evidence from non-psychiatric hospital care is limited. METHOD:We conducted semi-structured interviews with nine hospital-based non-psychiatric physicians in Japan (October 2023-March 2024) and analysed data using inductive thematic analysis. RESULTS:Physicians described accommodations in (1) medication management tailored to understanding, preferences, and home support; (2) relationship-centred communication to elicit symptoms and confirm comprehension; and (3) flexible care processes, including time, environment, and team roles. They mitigated risks through witnessed explanations, clear documentation, and proactive coordination with nurses and family members. CONCLUSIONS:Practical, workflow-embedded accommodations are common in non-psychiatric settings and could be strengthened by structured communication supports and systematic information sharing.