The prevalence of potential drug-drug interactions in adults with intellectual disability.
Each extra drug raises interaction danger for adults with ID—audit the list once they hit five meds.
01Research in Context
What this study did
The team looked at 217 adults with intellectual disability who lived in the community. They checked every medicine each person took and ran a computer scan for drug-drug interactions.
What they found
Clinically important interactions showed up in a large share of the group. The risk jumped sharply once a person took five or more medicines.
How this fits with other research
Heald et al. (2020) counted the same 217 adults and found that 38 % were already on polypharmacy. The new paper shows what that polypharmacy means: more danger of harmful mixes.
Klein et al. (2024) looked at youth with IDD and saw one in three on two or more psychotropics. The adult and youth data now line up—polypharmacy starts early and keeps climbing.
Andrews et al. (2024) focused on adults with memory complaints and used the Drug Burden Index. Their tool measures anticholinergic and sedative load, while the present paper counts raw interaction pairs. Both studies shout the same warning: more meds equal more risk, just measured in different units.
Why it matters
If your client with ID reaches five medicines, pause and ask the doctor or pharmacist to run a fresh interaction screen. Add the list to your behavior plan—side-effects can mimic or worsen challenging behavior. Share the scan results at team meetings so everyone watches for red-flag symptoms instead of blaming the disability.
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02At a glance
03Original abstract
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.
Journal of intellectual disability research : JIDR, 2021 · doi:10.1111/jir.12844