Medication Management in Long Term Care (LTC) for People Ageing with Intellectual Disabilities (PAWID) is not a 'simple process'

Background: A growing body of literature documents multiple morbidities and multiple medication use among PAWID who are some of the most vulnerable people in society with specialized medication needs. Medication management... [ view full abstract ]

Background:
A growing body of literature documents multiple morbidities and multiple medication use among PAWID who are some of the most vulnerable people in society with specialized medication needs. Medication management has emerged as the greatest problem area for social care providers in England. In Ireland in 2012 8.6% of all medication related adverse events were reported from the disability sector.

Aims:
To determine the level of medication use in a LTC centre that was home to 129 PAWID.

Methods:
Permission received from the Research Ethics Committee of the service provider. Data on medication use was extracted by the on site pharmacist from the Medication Prescription Record System and entered into EXCELL.
Findings:
• 31,614 oral solid form medications (tablets/capsules) administered in 28 days with average number solid form medications administered per day = 1,129

• 57 people prescribed liquid medications, 10 prescribed eye preparations, 17 prescribed nebulised medications, 60 prescribed medication in sachet form

Conclusion:
Medication administration to PAWID in LTC may seem a simple process to those not involved. Patient centred knowledge is required by prescribers, pharmacists and nurses.
Although medication administration may seem to be a ‘simple’ nursing task, the combination of multiple medication use and medical complexity in this population means that it is often more complex than fully realized by those not involved in the process.

Implications:
Pharmacists that serve PAWID must be aware of and sensitive to the unique medication needs and vulnerabilities of this population. Medication distribution models should be employed that maximize the safety, efficacy and efficiency of medication administration to this vulnerable population.
Medication use is the main therapeutic intervention in this population. It is important that all nursing, medical and pharmacy personnel, service provider management and policy makers are aware of the complexity of the medication use process.