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Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: A cross-sectional observational nationwide study

O'Dwyer, M
; 
Peklar, J
; 
McCallion, P
; 
McCarron, M
; 
Henman, MC
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Journal Article
Date
2016-01-01
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Subject
intellectual disability
 multimorbidity
 polypharmacy
 Adult
 Aged
 Aged, 80 and over
 Aging
 Anticonvulsants
 Antipsychotic Agents
 Chronic Disease
 Cross-Sectional Studies
 Female
 Humans
 Intellectual Disability
 Ireland
 Laxatives
 Logistic Models
 Longitudinal Studies
 Male
 Middle Aged
 Multivariate Analysis
 Pain Measurement
 Polypharmacy
 Risk Factors
 Surveys and Questionnaires
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http://hdl.handle.net/20.500.12613/5166
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DOI
10.1136/bmjopen-2015-010505
Abstract
Objectives: (1) To evaluate the prevalence of polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines) and (2) to determine associated demographic and clinical characteristics in an ageing population with intellectual disabilities (IDs). Design: Observational cross-sectional study. Setting: Wave One (2009/2010) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). Participants: A nationally representative sample of 753 persons with ID, aged between 41 and 90 years. Participants/proxy reported medicines ( prescription and over the counter) taken on a regular basis; medication data was available for 736 participants (98%). Main outcome measures/interventions: Participants were divided into those with no polypharmacy (0-4 medicines), polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines). Medication use patterns were analysed according to demographic variables and reported chronic conditions. A multinomial logistic regression model identified factors associated with polypharmacy (5-9 medicines) and excessive polypharmacy (≥10 medicines). Results: Overall, 90% of participants reported use of medicines. Polypharmacy was observed in 31.5% of participants and excessive polypharmacy in 20.1%. Living in a residential institution, and reporting a mental health or neurological condition were strongly associated with polypharmacy and excessive polypharmacy after adjusting for confounders, but age or gender had no significant effect. Conclusions: Polypharmacy was commonplace for older adults with ID and may be partly explained by the high prevalence of multimorbidity reported. Review of appropriateness of medication use is essential, as polypharmacy places ageing people with ID at risk of adverse effects.,.
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