University of Michigan, College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109-1065, United States.
Institute on Community Integration, University of Minnesota, 150 Pillsbury Dr, SE, Minneapolis, MN 55455, United States.
Res Dev Disabil. 2022 Apr;123:104182. doi: 10.1016/j.ridd.2022.104182. Epub 2022 Feb 4.
BACKGROUND/AIMS: Persons with intellectual or developmental disabilities and who exhibit challenging behaviors are often prescribed medication to control behavior. Little is known about the environmental factors that may be associated with taking these medications.
This study examined the association between individual and intermediate or environmental factors and the documented use of medication for clients with intellectual or developmental disabilities (IDD) who exhibit challenging behavior, using the 2014-15 National Core Indicators Adult Consumer Survey dataset.
Individual-level variables associated with a higher likelihood of taking medication for persons with IDD exhibiting challenging behaviors included being of younger age, male gender, having moderate or severe intellectual disability, being ambulatory, communicating verbally, having a behavioral plan, requiring support for behavioral challenges, and having a history of mental illness. Environment-level variables included infrequently eating out and having less everyday choice. This study found that restrictions in opportunities to make choices in their life was associated with a greater likelihood of being on a medication for persons with IDD who exhibit challenging behavior. Living in group home settings also increased the likelihood of medication use. A limitation of the study is a lack of information on why medications were prescribed and whether they were intended to treat the challenging behavior.
This work has important implications for health providers, as addressing malleable social factors may provide an avenue for reducing challenging behaviors without the need for medication.
背景/目的：具有智力或发育障碍并表现出挑战性行为的人经常被开处方服用药物来控制行为。对于可能与服用这些药物相关的环境因素知之甚少。
本研究使用 2014-15 年国家核心指标成人消费者调查数据集，考察了个体和中间或环境因素与记录的智力或发育障碍（ID）患者挑战性行为药物使用之间的关联。
与具有挑战性行为的 ID 患者更有可能服用药物相关的个体水平变量包括年龄较小、男性、中度或重度智力残疾、能走动、能言语交流、有行为计划、需要支持行为挑战，以及有精神病史。环境水平变量包括外出就餐频率较低和日常选择较少。本研究发现，生活中限制选择机会与 ID 患者更有可能服用药物来治疗挑战性行为有关。居住在集体家庭环境中也增加了药物使用的可能性。这项研究的一个局限性是缺乏关于为什么开处方以及药物是否旨在治疗挑战性行为的信息。
这项工作对医疗保健提供者具有重要意义，因为解决可塑的社会因素可能为减少挑战性行为提供了一种无需药物治疗的途径。
