Background Physical distress resulting from medical problems has been found to cause increased behavior problems in with Intellectual Disabilities (ID). Despite this fact, little has been documented on the medical problems of individuals with ID admitted for inpatient psychiatric care. We conducted an exploratory investigation based on a retrospective chart review of the medical problems and medications for 198 people with ID who had been admitted to a specialized inpatient psychiatric unit. Most patients were referred for admission because of aggressive, disruptive and self-injurious behaviors. The average length of stay was 17.6 days. Method We tallied the total number of medical problems and medications listed in the patients’ discharge summaries. Because longer stays are disruptive, costly and associated with greater overall impairment, we examined the relationship between length of stay and frequency of discharge medical diagnoses. We also assessed whether or not the number of psychoactive medications correlated with the number of medical diagnoses. The effects of other demographic and diagnostic variables on rates of medical diagnoses and medications were also evaluated, including gender, age group (16–25, 26–45, 46–60, > 60), level of ID (Mild, moderate or severe ID), and diagnosis of an Autism Spectrum Disorder (ASD) or Down syndrome (DS). Results Inpatients with a higher number of medical diagnoses had longer lengths of stay (Spearman r = +.32, p < 0.0001). There was a significant correlation between number of psychoactive medications and number of medical problems (Spearman r = + .32, p < 0.0001). The most frequent medical comorbidity was constipation, reported in 60% of the inpatients (n = 118), while Gastro- Esophageal Reflux Disease (GERD) was identified in 38% (n = 75). Older inpatients had an increased number of medical problems, as might be expected, but a diagnosis of an ASD, gender, and level of ID had no detectible effect on rates of either medical diagnoses or medications. There were only 13 inpatients with DS; in this modest sample, it was found that they had higher rates of osteoarthritis, cardiac problems, hearing loss, hypothyroidism, and sleep apnea than peers without DS, as is consistent with previous findings on overrepresented conditions in this trisomy. Conclusions In the present study, individuals with ID admitted for inpatient psychiatric care exhibited high rates of medical problems, and these were associated with duration of inpatient stay. Based on these findings, further investigation of the effects of medical problems on behavior among individuals with ID admitted for inpatient psychiatric care is warranted.
Persons with intellectual and developmental disabilities (IDD) live 20 fewer years than the average person and almost 40% of their deaths are from preventable causes. They suffer from well-documented disparities in health and healthcare, and much of this inequity is rooted in information transfer failures between patients, their caregivers, and their healthcare providers. Tools to improve communication between these stakeholders, such as health checks and hand-held health records, or health passports, have been implemented in Europe, Australia and Canada with mixed results, and there are no standard information tools currently in widespread use in the U.S. We review the evidence of the effectiveness of these tools, as well as their barriers to adoption, to inform proposed development of next-generation information transfer tools most useful to patients with IDD and their healthcare providers. The repair of health information transfer failures will be a major step toward achieving health equity for this population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.