Polypharmacy Common for Older People with Intellectual Disability

Posted on: 06 April 2016

New findings from Trinity College Dublin’s IDS-TILDA study highlights that polypharmacy is commonplace among older adults with intellectual disabilities. The team’s research discovered that:

• People with intellectual disabilities are likely to be exposed to multiple medicines (polypharmacy) to treat a multiple chronic conditions – 20% of participants used 10 or more medicines; over 30% used between five and nine.
• While polypharmacy, when used appropriately, plays a critical role in maintaining health, there is clear evidence that it is also associated with increased prescribing errors, and a higher prevalence of drug related adverse effects as more drugs are prescribed

These latest findings, which have just been published in the journal BMJ Open, are drawn from Wave 1 of IDS-TILDA, a nationally representative longitudinal study of older adults with intellectual disability by researchers from Trinity.

As people with intellectual disability continue to move from institutional to community settings in Ireland, this research is significant as it highlights the need for education and interventions to ensure appropriate provision of medicines.

Professor Mary McCarron, the Principal Investigator for IDS-TILDA and Dean of the Faculty of Health Sciences noted: “This is the first time there has been a comprehensive review of medicines use in people with intellectual disabilities, and particularly older people with intellectual disabilities in Ireland.

“The longitudinal nature of our study will allow us to provide a comprehensive insight into changes in medication patterns as people with intellectual disability age and move into community settings and will enable us to examine the effect of multiple medicines on health outcomes and quality of life.”

Lead author and Assistant Professor in the School of Pharmacy and Pharmaceutical Sciences Dr Máire O’Dwyer commented: “Our findings highlight that polypharmacy is commonplace for older adults with intellectual disabilities in Ireland, reflecting the high prevalence of multiple chronic conditions experienced by people with intellectual disabilities. Comprehensive, regular reviews of medicines use are essential, given that polypharmacy may place older adults with intellectual disabilities at risk of side effects.”

Dr Martin Henman, co-author and Associate Professor in the School of Pharmacy and Pharmaceutical Sciences commented: “This study provides the first evidence that can be used as the basis for the development of guidelines and education to help health care professionals, especially general practitioners and community pharmacists in primary care who are called upon to care for older people with ID, as more of them begin to live in the community.

“It is also vital that information and education about polypharmacy is made available in an accessible format for people with intellectual disability, and their carers, and IDS-TILDA is looking to bring this work forward in the future.”

Initiatives to address these polypharmacy concerns will also likely benefit all older people especially those with cognitive impairment.

The paper ‘Factors associated with polypharmacy and excessive polypharmacy in older people with Intellectual Disability differ from the general population; a cross-sectional observational nationwide study’ is available here: http://bmjopen.bmj.com/content/6/4/e010505.full.pdf+html