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Medication Use of Adults With Developmental Disabilities Living in Group Homes in Ontario

Applied Health Research Question submitted to H-CARDD by the Ontario Ministry of Community and Social Services
Authors: Virginie Cobigo, Helene Ouellette-Kuntz & Crystal Samson

Background

Adults with developmental disabilities have high rates of physical and mental health problems. Although use of multiple medications may be warranted by these complex healthcare needs, "polypharmacy" carries risks of adverse reactions. Patterns of medication use may differ for individuals living in residential settings (i.e., group homes) compared to those living with family or alone.

Purpose

The purpose of this report was to examine medication use in adults with developmental disabilities living in Ontario Ministry of Community and Social services-funded group homes and to compare this to adults with developmental disabilities as a whole.

Methods

A cohort of Ontario adults with developmental disabilities aged 18 to 64 years was created using health and social services administrative data from the Institute for Clinical Evaluative Sciences and the Ontario Ministry of Community and Social Services. We studied 7,322 adults with developmental disabilities living in group homes and compared them to adults with developmental disabilities as a whole. Medication use was reported as of October 1, 2009.

Results

  • Among adults with developmental disabilities living in group homes, more than 80% were dispensed two or more medications concurrently. This proportion was much higher than that in adults with developmental disabilities as a whole.
  • Similar to adults with developmental disabilities as a whole, the most common medications dispensed to adults with developmental disabilities living in group homes were psychotropic medications; antipsychotics, sedatives, and anticonvulsants were dispensed most often.
  • Although multiple medication use increased with increasing morbidity in both groups, the difference was not as drastic among adults with developmental disabilities living in group homes. Multiple medication use was also higher in adults with developmental disabilities living in group homes in each age group.  
  • Among adults with developmental disabilities living in group homes who were dispensed antipsychotics, two or more antipsychotics were sometimes dispensed, even to individuals with no psychiatric diagnosis. This occurred more often than in adults with developmental disabilities as a whole.

Conclusions and Implications

Adults with developmental disabilities living in group homes are more likely to be dispensed multiple medications compared to adults with developmental disabilities in Ontario as a whole. Older age and morbidity do not explain these discrepancies. Adults with developmental disabilities living in group homes need better monitoring to ensure that inappropriate prescribing (e.g., psychotropic medications for challenging behaviours) does not occur.