Medication use among Australian adults with intellectual disability in primary healthcare settings: A cross-sectional study

Doan, Tan; Lennox, Nicholas; Taylor-Gomez, Miriam; Ware, Robert S.

doi:10.3109/13668250.2013.778968

Cited by 70 publications

(59 citation statements)

References 23 publications

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“…The lower rate of medications per 100 problems for the ‘ID’ group compared with the ‘non‐ID’ group is in contrast to previous research which showed elevated medication rates for people with an ID (Straetmans et al ; Sheehan et al ; Doan et al ). We are unable to interpret these findings without first understanding what medications were being prescribed.…”

Section: Discussioncontrasting

confidence: 94%

Primary health care for people with an intellectual disability: an exploration of consultations, problems identified, and their management in Australia

Weise

Pollack

Britt

et al. 2017

J intellect Disabil Res

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The significant differences in consultations, problems identified and managed suggest that GPs may require additional support to (1) identify and manage common medical conditions experienced by people with an ID; (2) manage the increased time required for consultations; and (3) directly consult with people with an ID. Further research is required to determine why GPs managed problems in a significantly different way for people with an ID.

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Section: Discussioncontrasting

confidence: 94%

Primary health care for people with an intellectual disability: an exploration of consultations, problems identified, and their management in Australia

Weise

Pollack

Britt

et al. 2017

J intellect Disabil Res

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“…In Straetmans et al's study, the most common prescription to people with IDs was shown to be psycholeptic drugs, with a reported prevalence of 63% compared with 6.5% in the general population . Doan et al reported a prevalence of 35% psychotropic drug use in the ID sample, with antipsychotics being the most common agent (21%) …”

Section: Introductionmentioning

confidence: 99%

Prevalence of drug use among adults with intellectual disabilities compared with drug use in the general population

Hove¹,

Biringer²,

Havik

et al. 2019

Pharmacoepidemiology and Drug

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Purpose Individuals with intellectual disabilities (IDs) have more health problems, a poorer general health, and a shorter life expectancy than individuals in general. High rates of drug use in IDs have been reported. Despite the increasing interest in health problems in individuals with IDs, little is known about their drug use. Method Drug use in a community sample of adults with IDs (N = 593) was compared with dispensed drugs in a time‐, age‐, and region‐matched comparison group of adults in Western Norway (N = 289 325). A logistic regression model was employed by using the main group effect to describe and analyze the differences between the ID sample and the comparison sample and by using the interaction term (group × age) to describe the rate change differences from the reference age (18‐30 years) between the two groups. Results Total drug use in the ID sample was 62% compared with 50% in the reference sample (P = 0.0001). The high prevalence of drugs for the nervous system (ATC N) in the ID sample (50%) explained the difference. From age 51 and over, the increase in the drug use rate for the cardiovascular disease was significantly lower in the ID sample than in the reference sample (P value range: 0.002‐0.019). Conclusions Adults with IDs use more drugs than adults in general. However, the findings showed lower rates of drug use in the ID sample than in the general population for drugs targeting diseases that are the leading causes of death in individuals with IDs.

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“…This was lower than that reported in Scotland during 2002-4 (49.5%), 95 but more similar to other international cross-sectional findings from the Netherlands (32%), 113 Norway (37%) 114 and Australia (35%). 115 Although these studies generally showed that antipsychotics were the most frequent type of psychotropic medication being prescribed to this group, in our study antipsychotics and antidepressants were equally likely to be prescribed.…”

Section: Prescribingmentioning

confidence: 87%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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Background People with intellectual disability (ID) have poorer health than the general population; however, there is a lack of comprehensive national data describing their health-care needs and utilisation. Annual health checks for adults with ID have been incentivised through primary care since 2009, but only half of those eligible for such a health check receive one. It is unclear what impact health checks have had on important health outcomes, such as emergency hospitalisation. Objectives To evaluate whether or not annual health checks for adults with ID have reduced emergency hospitalisation, and to describe health, health care and mortality for adults with ID. Design A retrospective matched cohort study using primary care data linked to national hospital admissions and mortality data sets. Setting A total of 451 English general practices contributing data to Clinical Practice Research Datalink (CPRD). Participants A total of 21,859 adults with ID compared with 152,846 age-, gender- and practice-matched controls without ID registered during 2009–13. Interventions None. Main outcome measures Emergency hospital admissions. Other outcomes – preventable admissions for ambulatory care sensitive conditions, and mortality. Data sources CPRD, Hospital Episodes Statistics and Office for National Statistics. Results Compared with the general population, adults with ID had higher levels of recorded comorbidity and were more likely to consult in primary care. However, they were less likely to have long doctor consultations, and had lower continuity of care. They had higher mortality rates [hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.3 to 3.9], with 37.0% of deaths classified as being amenable to health-care intervention (HR 5.9, 95% CI 5.1 to 6.8). They were more likely to have emergency hospital admissions [incidence rate ratio (IRR) 2.82, 95% CI 2.66 to 2.98], with 33.7% deemed preventable compared with 17.3% in controls (IRR 5.62, 95% CI 5.14 to 6.13). Health checks for adults with ID had no effect on overall emergency admissions compared with controls (IRR 0.96, 95% CI 0.87 to 1.07), although there was a relative reduction in emergency admissions for ambulatory care-sensitive conditions (IRR 0.82, 95% CI 0.69 to 0.99). Practices with high health check participation also showed a relative fall in preventable emergency admissions for their patients with ID, compared with practices with minimal participation (IRR 0.73, 95% CI 0.57 to 0.95). There were large variations in the health check-related content that was recorded on electronic records. Limitations Patients with milder ID not known to health services were not identified. We could not comment on the quality of health checks. Conclusions Compared with the general population, adults with ID have more chronic diseases and greater primary and secondary care utilisation. With more than one-third of deaths potentially amenable to health-care interventions, improvements in access to, and quality of, health care are required. In primary care, better continuity of care and longer appointment times are important examples that we identified. Although annual health checks can also improve access, not every eligible adult with ID receives one, and health check content varies by practice. Health checks had no impact on overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Future work No formal cost-effectiveness analysis of annual health checks was performed, but this could be attempted in relation to our estimates of a reduction in preventable emergency admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Medication use among Australian adults with intellectual disability in primary healthcare settings: A cross-sectional study

Abstract: People with ID use a broad range of medications. Psychotropic medications continue to be the most predominant agents prescribed for this population. Psychotropic medication use is positively associated with having a psychiatric illness and challenging behaviours.

Cited by 70 publications

References 23 publications

Primary health care for people with an intellectual disability: an exploration of consultations, problems identified, and their management in Australia

Primary health care for people with an intellectual disability: an exploration of consultations, problems identified, and their management in Australia

Prevalence of drug use among adults with intellectual disabilities compared with drug use in the general population

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

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