Peklar Jure, Kos Mitja, O'Dwyer Máire, McCarron Mary, McCallion Philip, Kenny Rose Anne, Henman Martin C
Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
PLoS One. 2017 Sep 6;12(9):e0184390. doi: 10.1371/journal.pone.0184390. eCollection 2017.
Understanding the medication and supplement use of aging people is critical to ensuring that health service providers in primary care can optimise use of these agents. An increasing number of people with different levels of intellectual disability (ID) are living in the community and becoming for the first time substantial users of primary health care services. This, however, brings new challenges that need to be addressed at the primary health care level. We quantified the use of medicines and food supplements and described the associated patterns of morbidity in the two comparable cohorts of aging population with and without intellectual disability.
This research aligned participants of 50 years and over who lived in the community from two nationally representative cohorts of older people; those with ID from the Intellectual Disability Supplement (n = 238) and those without ID (n = 8,081) from the Irish Longitudinal Study on Ageing.
Data showed that both medication and supplement use in the two groups was prevalent but that those with ID received more of both medications and supplements (e.g. polypharmacy was 39.0% in ID vs. 18.1% in non-ID cohort). Moreover, based on an analysis of the therapeutic groups and medications used that treatment was more intense in the ID cohort (95.8 vs. 7.0 International Non-proprietary Names per 100 participants). Supplement use was almost twice as prevalent in the ID group but substantially less diverse with only 10 types of supplements reported. Morbidity was higher in the ID group and showed a higher prevalence of neurological and mental health disorders.
The results highlight that the burden of therapy management and the potential risks in those ageing with ID differs substantially from those ageing without ID. Understanding the medication and supplement use of people aging with intellectual disability (ID) is critical to ensuring that health service providers in primary/ambulatory care can optimise use of these agents.
了解老年人的药物和补充剂使用情况对于确保初级保健中的医疗服务提供者能够优化这些药物的使用至关重要。越来越多不同智力残疾（ID）程度的人生活在社区中，并首次成为初级卫生保健服务的大量使用者。然而，这带来了新的挑战，需要在初级卫生保健层面加以解决。我们对有智力残疾和无智力残疾的两个可比老年人群队列中的药物和食品补充剂使用情况进行了量化，并描述了相关的发病模式。
本研究纳入了来自两个具有全国代表性的老年人群队列中50岁及以上居住在社区的参与者；来自智力残疾补充队列的有智力残疾者（n = 238）和来自爱尔兰老龄化纵向研究的无智力残疾者（n = 8,081）。
数据显示两组的药物和补充剂使用都很普遍，但有智力残疾者服用的药物和补充剂更多（例如，多重用药在有智力残疾者中为39.0%，而在无智力残疾队列中为18.1%）。此外，基于对治疗组和使用药物的分析，有智力残疾队列中的治疗更为密集（每100名参与者中有95.8个国际非专利药名，而无智力残疾队列中为7.0个）。补充剂的使用在有智力残疾组中几乎是两倍，但种类要少得多，仅报告了10种补充剂。有智力残疾组的发病率更高，神经和心理健康障碍的患病率也更高。
结果表明，有智力残疾的老年人的治疗管理负担和潜在风险与无智力残疾的老年人有很大不同。了解有智力残疾（ID）的老年人的药物和补充剂使用情况对于确保初级/门诊护理中的医疗服务提供者能够优化这些药物的使用至关重要。
