This poster will present the methodology and early findings of a realist review of approaches to prevent and reduce the use of restrictive practices on adults with learning disabilities in healthcare organisations. A realist synthesis encompasses a theory-driven interpretation to make sense of complex approaches. The review iteratively progressed through four steps: step 1 – locate existing theories and approaches; step 2 – a systematic search of evidence; step 3 – data extraction and organisation; and step 4 – synthesising the evidence. A project stakeholder group and patient and public involvement were convened to advise throughout. An initial programme theory (IPT) consisting of four subcomponents including interpersonal interactions, service user involvement, carers’ role and invested organisation were outlined that postulated the reduction in restrictive practice use. Fifty-three relevant articles, thus far, have been identified that will be used to refine the IPT. Findings will provide recommendations for practice and policymaking.