Postdoctoral Research Fellow The Ohio State University Columbus, United States
Background: Patients with intellectual disabilities (IDs) tend to use multiple medicines (polypharmacy) as they live with multiple chronic diseases, requiring polypharmacy (concurrent use of ≥ 5 medicine) and hyperpolypharmacy (concurrent use of ≥ 10 medicine) therapies to cure or reduce the symptoms of each disease. However, limited data are available on the prevalence of polypharmacy and associated risk factors in patients with IDs.
Objectives: The aim of this study was to (1) describe the prevalence of polypharmacy and hyperpolypharmacy among patients with IDs, (2) commonly prescribed medications in patients with IDs, and (3) to evaluate the risk factors of polypharmacy in patients with IDs.
Methods: We collected potential articles from PubMed, Scopus, Web of Science, and bibliographies from relevant reviews. The search and selection of eligible study was ongoing until December 31, 2022. Observational studies that reported the prevalence of polypharmacy and hyperpolypharmacy in patients with IDs were selected. We extracted data on prevalence, patient numbers, commonly prescribed medications, and factors associated with polypharmacy. The meta-analysis was performed using a random-effects model.
Results: Ten studies were included in our study. The overall prevalence of polypharmacy and hyperpolypharmacy in patients with IDs was 31.9% (95%CI: 24.3% - 40.5%) and 14.5% (95%CI: 4.90% - 35.7%), respectively. The overall prevalence was slightly higher in European countries (34.2%, 95%CI: 23.4% - 47.0%) than in North American countries (32.9%, 95%CI: 20.2% - 48.5%). The severity of IDs (Moderate: OR 1.39, 95%CI: 0.95 – 2.05, severe: OR 2.56, 95%CI: 1.06 – 6.16), mental disorders, and hypertension were associated with an increased risk of polypharmacy. Moreover, antipsychotics, anticonvulsants, anxiolytics, benzodiazepines, laxatives, and analgesics were commonly prescribed medications in patients with IDs.
Conclusions: The prevalence of polypharmacy and hyperpolypharmacy was high in patients with IDs. More studies are needed to investigate the effects of age, gender, race/ethnicity, and socioeconomic status on polypharmacy in patients with IDs.
