Psychotropic medication in adults with mental retardation: prevalence, and prescription practices

Holden, Børge; Gitlesen, Jens Petter

doi:10.1016/j.ridd.2004.03.004

Cited by 102 publications

(122 citation statements)

References 14 publications

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“…We provided an alternative summary (and did not count antiepileptic drugs), describing instead the proportion of adults with ID who received a psychotropic drug at any time during single year (2011), and found a similar 4 in 10 proportion. This was lower than that reported in Scotland during 2002-4 (49.5%), 95 but more similar to other international cross-sectional findings from the Netherlands (32%), 113 Norway (37%) 114 and Australia (35%). 115 Although these studies generally showed that antipsychotics were the most frequent type of psychotropic medication being prescribed to this group, in our study antipsychotics and antidepressants were equally likely to be prescribed.…”

Section: Prescribingsupporting

confidence: 68%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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Background People with intellectual disability (ID) have poorer health than the general population; however, there is a lack of comprehensive national data describing their health-care needs and utilisation. Annual health checks for adults with ID have been incentivised through primary care since 2009, but only half of those eligible for such a health check receive one. It is unclear what impact health checks have had on important health outcomes, such as emergency hospitalisation. Objectives To evaluate whether or not annual health checks for adults with ID have reduced emergency hospitalisation, and to describe health, health care and mortality for adults with ID. Design A retrospective matched cohort study using primary care data linked to national hospital admissions and mortality data sets. Setting A total of 451 English general practices contributing data to Clinical Practice Research Datalink (CPRD). Participants A total of 21,859 adults with ID compared with 152,846 age-, gender- and practice-matched controls without ID registered during 2009–13. Interventions None. Main outcome measures Emergency hospital admissions. Other outcomes – preventable admissions for ambulatory care sensitive conditions, and mortality. Data sources CPRD, Hospital Episodes Statistics and Office for National Statistics. Results Compared with the general population, adults with ID had higher levels of recorded comorbidity and were more likely to consult in primary care. However, they were less likely to have long doctor consultations, and had lower continuity of care. They had higher mortality rates [hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.3 to 3.9], with 37.0% of deaths classified as being amenable to health-care intervention (HR 5.9, 95% CI 5.1 to 6.8). They were more likely to have emergency hospital admissions [incidence rate ratio (IRR) 2.82, 95% CI 2.66 to 2.98], with 33.7% deemed preventable compared with 17.3% in controls (IRR 5.62, 95% CI 5.14 to 6.13). Health checks for adults with ID had no effect on overall emergency admissions compared with controls (IRR 0.96, 95% CI 0.87 to 1.07), although there was a relative reduction in emergency admissions for ambulatory care-sensitive conditions (IRR 0.82, 95% CI 0.69 to 0.99). Practices with high health check participation also showed a relative fall in preventable emergency admissions for their patients with ID, compared with practices with minimal participation (IRR 0.73, 95% CI 0.57 to 0.95). There were large variations in the health check-related content that was recorded on electronic records. Limitations Patients with milder ID not known to health services were not identified. We could not comment on the quality of health checks. Conclusions Compared with the general population, adults with ID have more chronic diseases and greater primary and secondary care utilisation. With more than one-third of deaths potentially amenable to health-care interventions, improvements in access to, and quality of, health care are required. In primary care, better continuity of care and longer appointment times are important examples that we identified. Although annual health checks can also improve access, not every eligible adult with ID receives one, and health check content varies by practice. Health checks had no impact on overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Future work No formal cost-effectiveness analysis of annual health checks was performed, but this could be attempted in relation to our estimates of a reduction in preventable emergency admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Section: Prescribingsupporting

confidence: 68%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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“…In a study conducted in Turkey showed 62.5% of patients with MR using any of psychotropic drugs [17]. Psychotropic drugs use was found as 20.4% of MR cases in our sample and this ratio is relatively low, compared to above-mentioned rates, due to less comorbidity we found.…”

Section: Discussioncontrasting

confidence: 47%

Psychotropic Medication Use in Children and Adolescents with Mental Retardation (MR)

Temtek¹

2015

AJPN

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Abstract:Background: The aim of this study was to assess the medication use in children and adolescents with mental retardation (MR) retrospectively in a cross-sectional study. Method: Between June and December 2013, records of the children and adolescents admitted by our policlinic were retrospectively evaluated and those who had MR diagnosis were analyzed. Results: Male sex was found as statistically related to the presence of psychiatric comorbidity and the pervasive developmental disorders (PDD). At least one medical diagnosis accompanying with MR was found in 49.7% (n=781) of all patients. 79.6% (n=1252) of all patients did not use any medication, 16.7% (n=262) of all sample were using one medication agent, 3.5% (n=55) of patients were using combined pharmacotherapy. The predictors of psychotropic medication were the following: the presence of comorbid any of psychiatric disorders, having attention deficit hyperactivity disorder (ADHD), having conduct disorders (CD) and having anxiety disorders. Conclusions and Recommendations: This study has a descriptive nature of the children with MR admitted to the child psychiatry department. It was noticed that psychotropic agent use is preferable if there is a comorbid situation in mental retardation. There is a need for further studies with prospectively planned, multi-central with larger sampling in our country to draw up a way of health policies related to the children with MR.

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“…Anti-depressants are a risk factor for heart disease [29,30]. Between 20% and 66% of people with learning disabilities are given psychotropic medication [31]; however, it is often used as a form of behaviour management rather than to treat mental health problems [32,33] and its effectiveness in addressing challenging behaviour has been questioned [34]. Some respondents to our consultation mentioned that their attempts to question the need for such medication were rebuffed and they were given no option but to continue experiencing serious physical side effects.…”

Section: Resultsmentioning

confidence: 99%

Primary healthcare for people with mental health problems or learning disabilities

Nocon

Sayce²

2008

Health Policy

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Psychotropic medication in adults with mental retardation: prevalence, and prescription practices

Cited by 102 publications

References 14 publications

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Psychotropic Medication Use in Children and Adolescents with Mental Retardation (MR)

Primary healthcare for people with mental health problems or learning disabilities

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