{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:08:51Z","timestamp":1790863731551,"version":"4.1.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Polypharmacy and inappropriate prescription are frequent in vulnerable and multi-morbid populations. Adults with intellectual disability (ID) are at risk of being polymedicated because they often present with multiple comorbidities and challenging behaviors.<\/jats:p><jats:p><jats:bold>Aim:<\/jats:bold> The objective of this study was thus to evaluate the prevalence of potentially inappropriate medications (PIM) and polypharmacy in a hospital unit dedicated to adults with ID.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A 10-month prospective observational study took place at a hospital unit specializing in the care of adults with ID in Geneva, Switzerland. Once a week, health and prescription data were collected and screened for PIM according to preset definitions.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Fourteen patients consented to participate, leading to 20 hospitalization events assessed during the study. Hospitalizations lasted 12.8 weeks on average. ID severities ranged from mild to profound, all degrees of severity being equally represented. One hundred percent of the patients were polymedicated (defined as five drugs or more prescribed simultaneously). A mean number of 9.4 drugs were prescribed per week, including 5.3 psychotropic drugs. The number of prescribed drugs remained stable throughout the hospitalizations. Antipsychotics were the most prescribed drug class (19% of all prescribed drugs), followed by benzodiazepines (13%) and laxatives (12%). A total of 114 PIM were recorded with an average of 5.7 PIM per hospitalization.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> This study showed that polypharmacy and inappropriate prescription are very common in adults with ID, even though the literature and expert positions advocate for deprescription in these patients. Specific prescribing and deprescribing guidelines are needed for that specific population.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.614825","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T05:07:41Z","timestamp":1624597661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Prevalence of Polypharmacy and Inappropriate Medication in Adults With Intellectual Disabilities in a Hospital Setting in Switzerland"],"prefix":"10.3389","volume":"12","author":[{"given":"Sophie","family":"Lonchampt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Gerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Aubry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Desmeules","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kosel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Besson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12877-017-0621-2","article-title":"What is polypharmacy? A systematic review of definitions","volume":"17","author":"Masnoon","year":"2017","journal-title":"BMC Geriatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1002\/psb.1313","article-title":"Polypharmacy - appropriate, problematic or both?","volume":"26","author":"Payne","year":"2015","journal-title":"Prescriber."},{"key":"B3","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1517\/14740338.2013.827660","article-title":"Clinical consequences of polypharmacy in elderly","volume":"13","author":"Maher","year":"2014","journal-title":"Expert Opin Drug Saf."},{"key":"B4","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1001\/jamainternmed.2015.0324","article-title":"Reducing inappropriate polypharmacy: the process of deprescribing","volume":"175","author":"Scott","year":"2015","journal-title":"JAMA Intern Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1002\/pds.1984","article-title":"Adverse drug events in the outpatient setting: An 11-year national analysis","volume":"19","author":"Bourgeois","year":"2010","journal-title":"Pharmacoepidemiol Drug Saf."},{"key":"B6","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/j.1365-2125.2011.04010.x","article-title":"Potentially inappropriate medications in geriatric outpatients with polypharmacy: application of six sets of published explicit criteria","volume":"72","author":"Chang","year":"2011","journal-title":"Br J Clin Pharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1001\/archinte.151.9.1825","article-title":"Explicit criteria for determining inappropriate medication use in nursing home residents","volume":"151","author":"Beers","year":"1991","journal-title":"Arch Intern Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/0895-4356(92)90144-C","article-title":"A method for assessing drug therapy appropriateness","volume":"45","author":"Hanlon","year":"1992","journal-title":"J Clin Epidemiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1111\/jir.12119","article-title":"Characteristics and the trajectory of psychotropic medication use in general and antipsychotics in particular among adults with an intellectual disability who exhibit aggressive behaviour","volume":"59","author":"Deb","year":"2015","journal-title":"J Intellect Disabil Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1176\/appi.ps.201300029","article-title":"Psychotropic prescribing for persons with intellectual disabilities and other psychiatric disorders","volume":"65","author":"Edelsohn","year":"2014","journal-title":"Psychiatr Serv."},{"key":"B11","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1080\/17843286.2015.1122332","article-title":"Analysis of drug use in institutionalized individuals with intellectual disability and tube feeding","volume":"71","author":"Joos","year":"2016","journal-title":"Acta Clin Belg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3071","DOI":"10.1016\/j.ridd.2014.07.060","article-title":"Prevalence and factors associated with polypharmacy in Victorian adults with intellectual disability","volume":"35","author":"Haider","year":"2014","journal-title":"Res Dev Disabil."},{"key":"B13","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.ridd.2016.03.014","article-title":"Medication review using a Systematic Tool to Reduce Inappropriate Prescribing (STRIP) in adults with an intellectual disability: a pilot study","volume":"55","author":"Zaal","year":"2016","journal-title":"Res Dev Disabil."},{"key":"B14","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1111\/jcpt.12059","article-title":"Application of the STOPP\/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact","volume":"38","author":"Hill-Taylor","year":"2013","journal-title":"J Clin Pharm Ther."},{"key":"B15","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/S0140-6736(07)61091-5","article-title":"Appropriate prescribing in elderly people: how well can it be measured and optimised?","volume":"370","author":"Spinewine","year":"2007","journal-title":"Lancet."},{"key":"B16","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1002\/ddrr.119","article-title":"Pharmacotherapy of disruptive behavior in mentally retarded subjects: a review of the current literature","volume":"16","author":"H\u00e4\u00dfler","year":"2010","journal-title":"Dev Disabil Res Rev."},{"key":"B17","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/j.1365-2788.2010.01352.x","article-title":"Olanzapine vs. risperidone in treating aggressive behaviours in adults with intellectual disability: a single blind study","volume":"55","author":"Amore","year":"2011","journal-title":"J Intellect Disabil Res."},{"key":"B18","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s11126-008-9077-z","article-title":"A review of empirical evidence of somatic treatment options for the MI\/DD population","volume":"79","author":"Ulzen","year":"2008","journal-title":"Psychiatr Q."},{"key":"B19","doi-asserted-by":"publisher","first-page":"S124","DOI":"10.1542\/peds.2015-2851K","article-title":"Pharmacologic treatment of severe irritability and problem behaviors in autism: a systematic review and meta-analysis","volume":"137","author":"Fung","year":"2016","journal-title":"Pediatrics."},{"key":"B20","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1517\/14656566.2016.1154536","article-title":"Psychopharmacological interventions in autism spectrum disorder","volume":"17","author":"Accordino","year":"2016","journal-title":"Expert Opin Pharmacother."},{"key":"B21","volume-title":"First- and Second-Generation Antipsychotics in Children and Young Adults: Systematic Review Update","author":"Pillay","year":"2017"},{"key":"B22","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/j.1365-2788.2007.00981.x","article-title":"Atypical antipsychotic medication improves aggression, but not self-injurious behaviour, in adults with intellectual disabilities","volume":"52","author":"Ruedrich","year":"2007","journal-title":"J Intellect Disabil Res."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.4088\/JCP.v65n0907","article-title":"Treatment of behavior disorders in mental retardation: report on transitioning to atypical antipsychotics, with an emphasis on risperidone","volume":"65","author":"Aman","year":"2004","journal-title":"J Clin Psychiatry."},{"key":"B24","unstructured":"BhaumikS\n            BranfordD\n            BarrettM\n            GangadharanSK\n          The Frith Prescribing Guidelines for People With Intellectual Disability."},{"key":"B25","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/S1359-6446(04)03039-9","article-title":"Autism: a target of pharmacotherapies?","volume":"9","author":"Gerlai","year":"2004","journal-title":"Drug Discov Today."},{"key":"B26","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1097\/YCO.0000000000000233","article-title":"Pharmacotherapy for mental health problems in people with intellectual disability","volume":"29","author":"Ji","year":"2016","journal-title":"Curr Opin Psychiatry."},{"key":"B27","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1192\/apt.bp.113.011577","article-title":"Interventions for challenging behaviour in intellectual disability","volume":"20","author":"Ali","year":"2014","journal-title":"Adv Psychiatr Treat"},{"key":"B28","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1002\/mrdd.20031","article-title":"Self-injurious behavior and the efficacy of naltrexone treatment: a quantitative synthesis","volume":"10","author":"Symons","year":"2004","journal-title":"Ment Retard Dev Disabil Res Rev."},{"key":"B29","doi-asserted-by":"publisher","first-page":"I44","DOI":"10.1007\/s007870070018","article-title":"Opiate antagonists in children and adolescents","volume":"9","author":"Chabane","year":"2000","journal-title":"Eur Child Adolesc Psychiatry."},{"key":"B30","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1037\/t10453-000","article-title":"The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects","volume":"89","author":"Aman","year":"1985","journal-title":"Am J Ment Defic."},{"key":"B31","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1192\/bjp.180.1.67","article-title":"Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD)","volume":"180","author":"Roy","year":"2002","journal-title":"Br J Psychiatry."},{"key":"B32","volume-title":"Clinical Global Impression (CGI)","author":"Guy","year":"1976"},{"key":"B33","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1192\/bjp.172.1.11","article-title":"Health of the nation outcome scales (HoNOS): research and development","volume":"172","author":"Wing","year":"1998","journal-title":"Br J Psychiatry."},{"key":"B34","unstructured":"The Use of the WHO-UMC System for Standardised Case Causality Assessment"},{"key":"B35","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1111\/jar.12183","article-title":"Structured medication review to improve pharmacotherapy in people with intellectual disability and behavioural problems","volume":"29","author":"Scheifes","year":"2016","journal-title":"J Appl Res Intellect Disabil."},{"key":"B36","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/jir.12359","article-title":"Prevalence of psychotropic medication use and association with challenging behaviour in adults with an intellectual disability. A total population study","volume":"61","author":"Bowring","year":"2017","journal-title":"J Intellect Disabil Res."},{"key":"B37","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1002\/jcph.1311","article-title":"Changes in health-related quality of life in people with intellectual disabilities who discontinue long-term used antipsychotic drugs for challenging behaviors","volume":"59","author":"Ramerman","year":"2019","journal-title":"J Clin Pharmacol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1002\/ejp.1547","article-title":"Pain interventions in adults with intellectual disability: a scoping review and pharmacological considerations","volume":"24","author":"Lonchampt","year":"2020","journal-title":"Eur J Pain."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2042098618809927","article-title":"The risks of long-term use of proton pump inhibitors: a critical review","volume":"10","author":"Jaynes","year":"2018","journal-title":"Ther Adv Drug Saf."},{"key":"B40","first-page":"354","article-title":"Deprescribing proton pump inhibitors: evidence-based clinical practice guideline","volume":"63","author":"Farrell","year":"2017","journal-title":"Can Fam Physician."},{"key":"B41","doi-asserted-by":"publisher","first-page":"386","DOI":"10.23736\/S0026-4806.18.05705-1","article-title":"The appropriate use of proton-pump inhibitors","volume":"109","author":"Savarino","year":"2018","journal-title":"Minerva Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1038\/nrgastro.2017.117","article-title":"Proton-pump inhibitors: understanding the complications and risks","volume":"14","author":"Malfertheiner","year":"2017","journal-title":"Nature Rev Gastroenterol Hepatol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1055\/s-2005-864123","article-title":"Dyspepsia in chronic psychiatric patients","volume":"38","author":"Mookhoek","year":"2005","journal-title":"Pharmacopsychiatry."},{"key":"B44","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1016\/j.ridd.2013.02.005","article-title":"Prescription errors in older individuals with an intellectual disability: prevalence and risk factors in the Healthy Ageing and Intellectual Disability Study","volume":"34","author":"Zaal","year":"2013","journal-title":"Res Dev Disabil."},{"key":"B45","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1136\/bmj.j603","article-title":"Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system","volume":"356","author":"Wong","year":"2017","journal-title":"BMJ."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1007\/s00702-020-02214-x","article-title":"Prevalence and sort of pharmacokinetic drug-drug interactions in hospitalized psychiatric patients","volume":"127","author":"Hefner","year":"2020","journal-title":"J Neural Transm."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3238\/arztebl.2015.0001","article-title":"Probleme der Dauertherapie mit Benzodiazepinen und verwandten Substanzen: Verschreibungspraxis, Epidemiologie und Entzugsbehandlung","volume":"112","author":"Janhsen","year":"2015","journal-title":"Dtsch Arztebl Int."},{"key":"B48","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1176\/appi.ps.201700095","article-title":"Long-term use of benzodiazepines and nonbenzodiazepine hypnotics, 1999-2014","volume":"69","author":"Kaufmann","year":"2018","journal-title":"Psychiatric Serv."},{"key":"B49","doi-asserted-by":"publisher","first-page":"CD00204","DOI":"10.1002\/14651858.CD000204.pub2","article-title":"Anticholinergic medication for antipsychotic-induced tardive dyskinesia","volume":"1","author":"Bergman","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"B50","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ridd.2015.11.017","article-title":"Adverse events and the relation with quality of life in adults with intellectual disability and challenging behaviour using psychotropic drugs","author":"Scheifes","year":"2016","journal-title":"Res Dev Disabil."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e010505","DOI":"10.1136\/bmjopen-2015-010505","article-title":"Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: a cross-sectional observational nationwide study","volume":"6","author":"O'Dwyer","year":"2016","journal-title":"BMJ Open."},{"key":"B52","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.jpsychires.2012.01.014","article-title":"Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population","volume":"46","author":"Choong","year":"2012","journal-title":"J Psychiatr Res."},{"key":"B53","doi-asserted-by":"publisher","first-page":"201","DOI":"10.4212\/cjhp.v66i3.1261","article-title":"Deprescribing: what is it and what does the evidence tell us?","volume":"66","author":"Thompson","year":"2013","journal-title":"Can J Hosp Pharm."},{"key":"B54","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1111\/j.1365-2788.2012.01631.x","article-title":"Effects of controlled discontinuation of long-term used antipsychotics for behavioural symptoms in individuals with intellectual disability","volume":"58","author":"de Kuijper","year":"2014","journal-title":"J Intellect Disabil Res."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.614825\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T05:07:47Z","timestamp":1624597667000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.614825\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":54,"alternative-id":["10.3389\/fpsyt.2021.614825"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2021.614825","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]},"article-number":"614825"}}