Increase in number of drugs prescribed:
- More prescribing errors
- Higher prevalence of adverse drug reactions (ADR)

Cedarville University

Occurs in older adults when medicines that are prescribed without an evidence based indication. They also carry a high risk of adverse side effects that are significantly greater than when used in younger individuals. They are also not cost effective.

This includes Overprescription, underprescription, and misprescription of medications

Potentially Inappropriate Prescribing (PIP)

The use of multiple medications to treat a certain condition. Can cause side effects through drug-drug interaction.

Polypharmacy

O'Dwyer, M., McCallion, P., McCarron, M., & Henman, M. (2018). Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research. Therapeutic advances in drug safety, 9(9), 535–557. https://doi.org/10.1177/2042098618782785

Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research

In general population:
- Falls
- Increased risk of mortality
- Impaired physical functioning
- Impaired Cognitive Functioning

Risks of Potentially Inappropriate Prescribing (PIP)



Occurs when the side effects of a medication are misdiagnosed as another problem, leading to the prescription of more medication.  

People with ID may be at a higher risk because they may be unable to communicate the side effects that they are experiencing. 

Prescribing Cascade 

 - Living in Industrial settings
- Mental health conditions
- Neurological Conditions
- More common in Females

Factors Associated with Higher Rates of Polypharmacy in Adults with ID 


- Antipsychotics
- Antiepileptic drugs (AEDS)
- Antidepressants 
- Laxatives

The Most Common Therapeutic Drug Classes used in Adults with ID for Polypharmacy

Theraputic Classes in Older Population:
 - Cardiac Therapies
- Analgesics
- Gastrointestinal agents
- Antithrombotics


Polypharmacy in the General Older Population

A patient who has previously been exposed to polypharmacy may not receive other medications 
 - Challenges associated with communication
 - Diagnostic Overshadowing
 - Fear of drug-drug interaction with previously prescribed medications

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