The relationship between living arrangement and adherence to antiepileptic medications among individuals with developmental disabilities.

Ohan et al. (2015) compared how well adults with intellectual disability stick to their epilepsy medicine. They looked at pharmacy refill records across three living setups: family homes, semi-independent places, and group homes.

The team used a quasi-experimental design. They ranked adherence by how often prescriptions were filled on time.

People in family or semi-independent homes had lower adherence than those in group homes. The gap was big enough to matter clinically.

No other factor, like age or sex, explained the difference. Living arrangement alone predicted who missed doses.

At first glance this clashes with Pilowsky et al. (1998) and Singh et al. (1991). Those studies praised smaller, community settings for boosting independence and life satisfaction. They painted group homes as overly supervised and limiting.

The key is the outcome measured. Pilowsky et al. (1998) looked at adaptive behavior and happiness. Ohan et al. (2015) looked at pill-taking. A setting can give freedom and still leave medical needs unattended.

Qian et al. (2015), published the same year, adds a clue. They found that staff skill in group homes predicts resident engagement. Better staff may be why group homes also win on medication adherence.

If your client lives with family or alone, build extra layers of support. Add visual schedules, phone alerts, or nurse check-ins. Do not assume family care equals good care. Treat low supervision as a red flag for medication management and plan accordingly.