Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland
Background: Polypharmacy and inappropriate prescription are frequent in vulnerable and multi-morbid populations. Adults with intellectual disability (ID) are at risk of being polymedicated because they often present with multiple comorbidities and challenging behaviors.Aim: The objective of this stu...
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doaj-86e5157ccf39438d8f5d9cb1a80b4dee2021-06-25T05:07:30ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-06-011210.3389/fpsyt.2021.614825614825Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in SwitzerlandSophie Lonchampt0Sophie Lonchampt1Sophie Lonchampt2Fabienne Gerber3Jean-Michel Aubry4Jules Desmeules5Jules Desmeules6Markus Kosel7Marie Besson8Psychopharmacology Unit, Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Intensive Care, Pharmacology and Emergency, Geneva University Hospitals, Geneva, SwitzerlandUnit for Treatment and Assessment of In and Out Patients With Learning Disabilities and Autism Spectrum Disorders, Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Science, School of Pharmaceutical Sciences, University of Geneva, Geneva, SwitzerlandUnit for Treatment and Assessment of In and Out Patients With Learning Disabilities and Autism Spectrum Disorders, Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, SwitzerlandDivision of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Science, School of Pharmaceutical Sciences, University of Geneva, Geneva, SwitzerlandDivision of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Intensive Care and Pharmacology, Geneva University Hospitals, Geneva, SwitzerlandUnit for Treatment and Assessment of In and Out Patients With Learning Disabilities and Autism Spectrum Disorders, Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, SwitzerlandPsychopharmacology Unit, Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Intensive Care, Pharmacology and Emergency, Geneva University Hospitals, Geneva, SwitzerlandBackground: Polypharmacy and inappropriate prescription are frequent in vulnerable and multi-morbid populations. Adults with intellectual disability (ID) are at risk of being polymedicated because they often present with multiple comorbidities and challenging behaviors.Aim: The objective of this study was thus to evaluate the prevalence of potentially inappropriate medications (PIM) and polypharmacy in a hospital unit dedicated to adults with ID.Methods: A 10-month prospective observational study took place at a hospital unit specializing in the care of adults with ID in Geneva, Switzerland. Once a week, health and prescription data were collected and screened for PIM according to preset definitions.Results: Fourteen patients consented to participate, leading to 20 hospitalization events assessed during the study. Hospitalizations lasted 12.8 weeks on average. ID severities ranged from mild to profound, all degrees of severity being equally represented. One hundred percent of the patients were polymedicated (defined as five drugs or more prescribed simultaneously). A mean number of 9.4 drugs were prescribed per week, including 5.3 psychotropic drugs. The number of prescribed drugs remained stable throughout the hospitalizations. Antipsychotics were the most prescribed drug class (19% of all prescribed drugs), followed by benzodiazepines (13%) and laxatives (12%). A total of 114 PIM were recorded with an average of 5.7 PIM per hospitalization.Conclusions: This study showed that polypharmacy and inappropriate prescription are very common in adults with ID, even though the literature and expert positions advocate for deprescription in these patients. Specific prescribing and deprescribing guidelines are needed for that specific population.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.614825/fullintellectual disabilitypolypharmacyinappropriate prescriptionpsychotropic drugsdeprescription |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sophie Lonchampt Sophie Lonchampt Sophie Lonchampt Fabienne Gerber Jean-Michel Aubry Jules Desmeules Jules Desmeules Markus Kosel Marie Besson |
spellingShingle |
Sophie Lonchampt Sophie Lonchampt Sophie Lonchampt Fabienne Gerber Jean-Michel Aubry Jules Desmeules Jules Desmeules Markus Kosel Marie Besson Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland Frontiers in Psychiatry intellectual disability polypharmacy inappropriate prescription psychotropic drugs deprescription |
author_facet |
Sophie Lonchampt Sophie Lonchampt Sophie Lonchampt Fabienne Gerber Jean-Michel Aubry Jules Desmeules Jules Desmeules Markus Kosel Marie Besson |
author_sort |
Sophie Lonchampt |
title |
Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland |
title_short |
Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland |
title_full |
Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland |
title_fullStr |
Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland |
title_full_unstemmed |
Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland |
title_sort |
prevalence of polypharmacy and inappropriate medication in adults with intellectual disabilities in a hospital setting in switzerland |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychiatry |
issn |
1664-0640 |
publishDate |
2021-06-01 |
description |
Background: Polypharmacy and inappropriate prescription are frequent in vulnerable and multi-morbid populations. Adults with intellectual disability (ID) are at risk of being polymedicated because they often present with multiple comorbidities and challenging behaviors.Aim: The objective of this study was thus to evaluate the prevalence of potentially inappropriate medications (PIM) and polypharmacy in a hospital unit dedicated to adults with ID.Methods: A 10-month prospective observational study took place at a hospital unit specializing in the care of adults with ID in Geneva, Switzerland. Once a week, health and prescription data were collected and screened for PIM according to preset definitions.Results: Fourteen patients consented to participate, leading to 20 hospitalization events assessed during the study. Hospitalizations lasted 12.8 weeks on average. ID severities ranged from mild to profound, all degrees of severity being equally represented. One hundred percent of the patients were polymedicated (defined as five drugs or more prescribed simultaneously). A mean number of 9.4 drugs were prescribed per week, including 5.3 psychotropic drugs. The number of prescribed drugs remained stable throughout the hospitalizations. Antipsychotics were the most prescribed drug class (19% of all prescribed drugs), followed by benzodiazepines (13%) and laxatives (12%). A total of 114 PIM were recorded with an average of 5.7 PIM per hospitalization.Conclusions: This study showed that polypharmacy and inappropriate prescription are very common in adults with ID, even though the literature and expert positions advocate for deprescription in these patients. Specific prescribing and deprescribing guidelines are needed for that specific population. |
topic |
intellectual disability polypharmacy inappropriate prescription psychotropic drugs deprescription |
url |
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.614825/full |
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