Measuring drug burden in older adults with intellectual disabilities: Critical issues for consideration in finding the optimal measure to improve safety of medicines use |
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Authors: | Maire O’Dwyer Philip McCallion Mary McCarron Juliette O’Connell Martin Henman |
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Affiliation: | 1. School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin , Dublin 2, Ireland modwyer6@tcd.ie;3. College of Public Health, Temple University , PA, USA;4. Trinity Centre for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin , Dublin 2, Ireland;5. School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin , Dublin 2, Ireland |
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Abstract: | ABSTRACT Older adults with Intellectual Disability have been described as among the most medicated groups in society, with rates of polypharmacy significantly exceeding that of the general population. They are at heightened risk of medication-related harm and have high exposure to high-risk medications, for example, anticholinergic ad sedative medicines. There has been significant controversy internationally relating to the inappropriate use of antipsychotics for challenging behavior, often in the absence of a psychiatric diagnosis. Despite this, the evidence base of the safety of use of medicines in this population is lacking, the provision of healthcare is often suboptimal and this population is often excluded from Randomized Controlled Trials. In this editorial, we describe the unique challenges in ensuring safe and appropriate medicines in this population. We describe tools to date that has been used in this population to measure the burden of medicines that increase the risk of adverse outcomes. We outline current and future developments required to improve the quality and safety of medicines use in this population, for example, longitudinal cohort studies. |
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Keywords: | Medication related harm intellectual disabilities inappropriate prescribing polypharmacy |
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