Polypharmacy and psychotropic polypharmacy in adults with intellectual disability: a cross‐sectional total population study

McMahon, Martin J.; Hatton, Chris; Bowring, Darren Lee

doi:10.1111/jir.12775

Cited by 23 publications

(25 citation statements)

References 58 publications

(177 reference statements)

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“…In addition, there are 11 numerical definitions of polypharmacy which also classify the duration of drug treatment, about 4 numerical definitions which also include the health care setting and 16 descriptive definitions of polypharmacy [8,[14][15][16]30]. However, the few numerical definitions including the health care setting can be regarded as only numerical definitions which were used in a specific clinical setting.…”

Section: Definition Of Polypharmacymentioning

confidence: 99%

“…Five or more medications [27] Two or more medications for over 240 days [23] Five or more medications at hospital discharge [31] Necessary polypharmacy: "Necessary polypharmacy regimens should be considered additional medications that can optimize functional status and prevent disability in older adults. For older patients receiving NP regimens, the benefits outweigh the risks" [8] Six or more medications [32] Over five medications for 90 or more days [33] Five to nine medications during hospital stay [34] Qualitative polypharmacy: "prescription of five or more medications including at least one drug considered potentially inappropriate for older adults" [15] Ten or more medications [14] Five to nine medications for 90 or more days [35] Ten or more medications during hospital stay (also called excessive polypharmacy) [34,36] Psychotropic polypharmacy: "the concurrent use of two or more psychotropic agents in one individual" [16] Seven or more medications [37] Five or more medications in the same quarter of a year [38] -Appropriate polypharmacy: "optimization of medications for patients with complex and/or multiple conditions where medicine usage agrees with best evidence" [14,39] Five to nine medications [40] Five or more medications in the same month [41] -"Use of medications which are not clinically indicated" [14,42]…”

Section: Definition Of Polypharmacymentioning

confidence: 99%

“…Certainly, the concurrent intake of five or more drugs is the most common definition of polypharmacy in the literature [ 13 ]. Nevertheless, about 143 definitions of polypharmacy and associated terms exist according to a systematic review of definitions of polypharmacy [ 14 ] and other more recent publications [ 7 , 8 , 11 , 15 , 16 ]. The vast majority of those ( n = 112) are mere numerical definitions, meaning that only the number of drugs is used to check for the presence of polypharmacy in an individual [ 14 ].…”

Section: Search Strategymentioning

confidence: 99%

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Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

2021

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Background The number of older adults has been constantly growing around the globe. Consequently, multimorbidity and related polypharmacy have become an increasing problem. In the absence of an accepted agreement on the definition of polypharmacy, data on its prevalence in various studies are not easily comparable. Besides, the evidence on the potential adverse clinical outcomes related to polypharmacy is limited though polypharmacy has been linked to numerous adverse clinical outcomes. This narrative review aims to find and summarize recent publications on definitions, epidemiology and clinical consequences of polypharmacy. Methods The MEDLINE database was used to identify recent publications on the definition, prevalence and clinical consequences of polypharmacy using their respective common terms and their variations. Systematic reviews and original studies published between 2015 and 2020 were included. Results One hundred and forty-three definitions of polypharmacy and associated terms were found. Most of them are numerical definitions. Its prevalence ranges from 4% among community-dwelling older people to over 96.5% in hospitalized patients. In addition, numerous adverse clinical outcomes were associated with polypharmacy. Conclusion The term polypharmacy is imprecise, and its definition is yet subject to an ongoing debate. The clinically oriented definitions of polypharmacy found in this review such as appropriate or necessary polypharmacy are more useful and relevant. Regardless of the definition, polypharmacy is highly prevalent in older adults, particularly in nursing home residents and hospitalized patients. Approaches to increase the appropriateness of polypharmacy can improve clinical outcomes in older adults.

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Section: Definition Of Polypharmacymentioning

confidence: 99%

Section: Definition Of Polypharmacymentioning

confidence: 99%

Section: Search Strategymentioning

confidence: 99%

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Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

2021

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“…2019; McMahon et al . 2020). There is a growing evidence base that describes the incidence and associations of polypharmacy and psychotropic polypharmacy in this population (Haider et al .…”

Section: Introductionmentioning

confidence: 99%

“…A recent study (McMahon et al . 2020) has drawn attention to the need to consider the impact of adverse drug reactions in this population by considering the epidemiology of drug–drug interactions (DDI) given the potential to cause significant harm (Preston 2019).…”

Section: Introductionmentioning

confidence: 99%

The prevalence of potential drug–drug interactions in adults with intellectual disability

McMahon

Hatton

Bowring

et al. 2021

J intellect Disabil Res

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Background There is a high use of medications in adults with intellectual disability (ID). One implication of taking multiple medications is the potential for drug–drug interactions (DDIs). However, despite this being well highlighted in the mainstream literature, little is known about the incidence or associations of DDIs in the ID population. Methods This study describes the prevalence, patterns and associations of potential DDIs in a total administrative sample of adults with ID known to services in Jersey. Demographic, health‐related and medication data were collected from 217 adults known to ID services. Data were collected using a face‐to‐face survey. The Anatomical Therapeutic Chemical classification system was used to categorise medications, and Stockley's Drug Interaction Checker was used to classify potential DDIs. Drug–drug pairings were considered to be of clinical significance if they were to be ‘avoided, adjusted, monitored or required further information’. Results Potential DDIs of clinical significance were common. Exposure to potential DDIs of clinical significance was associated with being female, taking more than five medications (polypharmacy), living in residential care and having more health conditions. A simple regression was used to understand the effect of number of prescribed medications on potential DDIs of clinical significance. Every prescribed drug led to a 0.87 (95% confidence interval: 0.72–1.00) increase in having a potential DDI of clinical significance. Conclusion Adults with ID who live in residential care, who are female, exposed to polypharmacy and have more health conditions may be more likely to have potential DDIs of clinical significance. Urgent consideration needs to be given to the potential of DDIs in this population given their exposure to high levels of medication.

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Antipsychotic Drug Prescription and Behavioral Problems in Individuals with Intellectual Disability

Kuijper

Lenderink

2022

NeuroPsychopharmacotherapy

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Polypharmacy and psychotropic polypharmacy in adults with intellectual disability: a cross‐sectional total population study

Cited by 23 publications

References 58 publications

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

The prevalence of potential drug–drug interactions in adults with intellectual disability

Antipsychotic Drug Prescription and Behavioral Problems in Individuals with Intellectual Disability

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