Adverse drug event‐related hospitalisation in persons with neurodevelopmental disorders: a state‐wide retrospective cohort study

Abstract

Background Little is known about the sociodemographic and clinical characteristics of adverse drug events (ADEs) in patients with neurodevelopmental disorders (NDD). Objective The objective of this study was to describe and compare the demographic details of people with and without NDD hospitalised due to ADEs. Methods The all‐inclusive New South Wales Admitted Patient Data Collection from 2001 to 2014 was employed to identify ADE‐related hospitalisations in patients with NDD using the International Classification of Diseases 10th revision Australian modification codes. We derived case sets specific to different clinical groups and patient characteristics and compared proportional differences between patients with and without intellectual disability using chi squared tests. Results A total of 2173 patients with NDD were admitted for acute care of ADEs, accounting for 0.7% of all ADE‐related hospitalisations. Hospitalised ADEs among patients with NDD increased by twofold over the 14‐year study period. Psychotropic medications and opioid analgesic medications were leading causes of ADE‐related hospitalisations in patients with NDD. Compared with their counterparts, patients with NDD were younger, experienced more socio‐economic disadvantage and less private insurance coverage, suffered with less severe but different co‐morbid clinical conditions and incurred more challenges in the acute hospital care setting. Conclusion Although the pattern of ADE‐related hospitalisations in patients with NDD differed from that in patients without NDD, there is a lack of targeted healthcare programmes to meet their special needs. This study suggests the need for countermeasures in primary healthcare settings to reduce the burden of ADEs in this vulnerable group.

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“…The term Intellectual developmental disabilities refers to cases that are part of neurodevelopmental disorders such as mental disability, autism, motor disabilities, provocative behavior and mental health, as well as Down syndrome and other genetic syndromes. Furthermore, neurodevelopmental disorder is a diagnostic group in the new version of the International Classification of Diseases (ICD-11) that includes the " behavioral and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intellectual, motor, or social functional" such described on World Health Organization (Zhou, Du, Salvador-Carulla & Glasgow, 2019). The symptomatology of these disorders is the dysfunction of cognitive, communicative and social functions.…”

Hospital psychosocial interventions for patients with brain functional impairment: A retrospective cohort study

“…In addition to the lack of convincing evidence on efficacy, these pharmaceutical treatments are expensive and most have side effects that adversely impact physical function in these patients or require acute hospital care (Zhou et al . ).…”

“…Needs for mental health care and support are frequently seen in patients with NDD, BDD, or TBI, however, conventional pharmaceutical interventions have not been found to achieve permanent successful results for these patients with their complex physical and psychosocial needs (Gallagher & Herrmann 2015;Leskovec et al 2008;McConeghy et al 2012;Mercken et al 2011;Vandenberghe et al 2016). In addition to the lack of convincing evidence on efficacy, these pharmaceutical treatments are expensive and most have side effects that adversely impact physical function in these patients or require acute hospital care (Zhou et al 2019).…”

Rating scales to measure adverse effects of medications in people with intellectual disability: a scoping review

“…Drug-drug interactions, increased body fat, neurological damage, genetic abnormalities and differences in expression of metabolic enzymes responsible for drug degradation are factors which may contribute to altered effects, and adverse effects, of medications in this population [20][21][22]. These adverse effects can have serious clinical consequences, including hospitalisation [23]. Polypharmacy has also been found to be a predictor for mortality in older adults with ID [24].…”