Drug burden index to define the burden of medicines in older adults with intellectual disabilities: An observational cross‐sectional study

O’Connell, Juliette; Burke, Éilish; Mulryan, Niamh; O’Dwyer, Claire; Donegan, Clare; McCallion, Philip; McCarron, Mary; Henman, Martin; O'Dwyer, Máire

doi:10.1111/bcp.13479

Cited by 48 publications

(62 citation statements)

References 76 publications

(178 reference statements)

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“…This study used data from Wave 2 (2013/2014) of the ID Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA), a nationally representative study of older adults with ID in Ireland. This study has been described in detail elsewhere . Ethical approval for the study was granted by the Faculty of Health Sciences Research Ethics Committee in Trinity College Dublin and local and/or regional ethical committee approval was granted from each service provider (n = 138).…”

Section: Methodsmentioning

confidence: 99%

“…Polypharmacy : No polypharmacy was defined as exposure to 0 to 4 medications; polypharmacy was defined as exposure to 5 to 9 medications; excessive polypharmacy was defined as exposure to 10 or more medications. This categorisation was used previously in the IDS‐TILDA study and other epidemiological studies …”

Section: Methodsmentioning

confidence: 99%

“…Drug Burden Index : Drug Burden Index (DBI) was used to capture dose‐related exposure of an individual to regular anticholinergic and sedative medications. Full details of this measure are available in previous publications …”

Section: Methodsmentioning

confidence: 99%

“…In spite of the known associations between polypharmacy, anticholinergic and sedative exposure with frailty in older adults without ID, and the high levels of exposure to these amongst people with ID, little research has been performed to assess the association between frailty by any measure with medication exposure in older adults with ID.…”

Section: Introductionmentioning

confidence: 99%

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Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study

O’Connell

Henman

McMahon

et al. 2020

Pharmacoepidemiology and Drug

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Purpose: Recently, efforts have been made to quantify frailty among older adults with intellectual disability (ID). Medication exposure is associated with frailty among older adults without ID. However, there is little research on this association among older adults with ID. The aim of this study was to examine specifically in people with ID the association between frailty and medication exposure, including anticholinergic and sedative medication exposure. Methods: Data were drawn from Wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a nationally representative study of older adults with ID in Ireland. A modified version of Fried's frailty phenotype was constructed. Drug burden measures were polypharmacy, Drug Burden Index (DBI), Anticholinergic Cognitive Burden (ACB) and Sedative Load Model. Multinomial logistic regression was used to calculate odds ratios (ORs) and identify associations between frailty and drug burden.Results: This study included 570 participants with ID. Excessive polypharmacy (use of ≥10 medications) was significantly associated with being pre-frail (P = .017; OR = 2.56; 95% confidence interval [CI] 1.19-5.50) and frail (P < .001; OR 7.13; 95% CI 2.81-18.12), but DBI, ACB or Sedative Load score were not significantly associated with frailty status (P > .05).Conclusions: This is the first study to examine frailty and its association with medication use including anticholinergic and sedative medication burden among older adults with ID. Further research is required to investigate frailty as measured by other frailty models in relation to medication burden in older adults with ID. K E Y W O R D S frailty, intellectual disability, medication, pharmacoepidemiology 1 | INTRODUCTION Intellectual disability (ID) is a lifelong condition characterised by deficits in cognitive functioning and skills acquisition. 1 Many people with ID, particularly those over 40 years of age, experience multiple disability and premature multi-morbidity 2 and subsequently experience high levels of medication exposure. 3 Average life expectancy among people with ID has increased substantially over the last few decades. 4-6 Nonetheless, there is still inequity in health and early death due to avoidable healthcare issues among people with ID. 7 The concept of an ageing population which now includes people with ID further prompts study of frailty in this group.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study

O’Connell

Henman

McMahon

et al. 2020

Pharmacoepidemiology and Drug

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“…; Health Products Regulatory Authority ; O'Connell et al . ). Anti‐epileptics (N03A) which for the purpose of this study we renamed as mood stabilisers and added lithium (N05A). It was not possible to definitively conclude that changes to anti‐epileptic medication were for mood stabilisation as opposed to seizure control in participants with a diagnosis of epilepsy.…”

Section: Methodsmentioning

confidence: 97%

The association of life events and mental ill health in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing

Bond

Carroll

Mulryan

et al. 2019

J intellect Disabil Res

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Background Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. Methods The study was part of ‘The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing’. The frequency of life events was assessed using a 20‐item checklist, and the level of stress experienced was assessed using a three‐point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self‐report and proxy completed questionnaires. Results For the study population, 88.1% had been exposed to at least one life event in the preceding 12 months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self‐rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. Conclusions Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well‐being.

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Constipation‐associated factors in outpatients with schizophrenia: A multicenter questionnaire survey

Tazaki,

Yamada,

Sato

et al. 2024

Neuropsychopharm Rep

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Constipation is a prevalent gastrointestinal disorder that affects people globally, decreasing their quality of life and life expectancy. Individuals with schizophrenia often suffer from constipation, which could be a result of the illness itself or the side effects of psychotropic medications. However, little research has been conducted on factors contributing to constipation in individuals with schizophrenia. To address this issue, we conducted a survey using self‐administered questionnaires and medical records to identify factors associated with constipation in psychiatric outpatients. This study included 399 patients with schizophrenia, resulting in a high prevalence of constipation (43.4%). The analysis suggested that female gender, the doses of antiparkinsonian medications, and benzodiazepine sleeping pills may be associated with constipation.

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Drug burden index to define the burden of medicines in older adults with intellectual disabilities: An observational cross‐sectional study

Abstract: This is the first time DBI has been described in older adults with ID. Scores were much higher than those observed in the general population and higher scores were associated with higher dependence in Barthel index activities of daily living.

Cited by 48 publications

References 76 publications

Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study

Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study

The association of life events and mental ill health in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing

Constipation‐associated factors in outpatients with schizophrenia: A multicenter questionnaire survey

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