Contraceptive Provision to Postpartum Women With Intellectual and Developmental Disabilities: A Population-Based Cohort Study

ObjectivesTo describe factors associated with initiating antipsychotics and patterns of persistence to antipsychotic therapy in a large cohort of adults with intellectual and developmental disabilities.DesignPopulation-based cohort study.SettingOntario, Canada.ParticipantsAdults with intellectual and developmental disabilities (IDD) in Ontario.Outcome measuresWe used multivariable logistic regression to investigate patient characteristics associated with antipsychotic initiation. Patient characteristics studied included sociodemographic characteristics, measures of clinical comorbidity and health service use.ResultsAmong 39 244 individuals eligible for this study, 6924 (17.6%) initiated an antipsychotic over the accrual window, of whom 1863 (26.9%) had no psychiatric diagnosis in the prior 2 years. A number of factors were significantly associated with antipsychotic initiation, including male gender, residence in a group home, prior use of benzodiazepines, antidepressants or cognitive enhancers, a recent emergency department visit or mental health hospitalisation and a visit to a psychiatrist or family physician in the prior 90 days. In a secondary analysis, the association between antipsychotic initiation and age, prior diagnosis of diabetes or myocardial infarction and polypharmacy differed slightly on the basis of whether an individual had a previously diagnosed psychiatric disorder.ConclusionsFactors associated with the initiation of an antipsychotic differ according to the presence of a psychiatric diagnosis. Given the long duration of antipsychotic use in this population, future research is needed to understand the appropriateness of antipsychotic initiation among adults with IDD and the safety implications of long-term use of these products.

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Antenatal Hospitalization Among U.S. Women With Intellectual and Developmental Disabilities: A Retrospective Cohort Study

American Journal on Intellectual and Developmental Disabilities ◽

10.1352/1944-7558-123.5.399 ◽

2018 ◽

Vol 123 (5) ◽

pp. 399-411 ◽

Cited By ~ 5

Author(s):

Monika Mitra ◽

Susan L. Parish ◽

Karen M. Clements ◽

Jianying Zhang ◽

Tiffany A. Moore Simas

Keyword(s):

Cohort Study ◽

Developmental Disabilities ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Hospital Utilization ◽

Intellectual And Developmental Disabilities ◽

Health Care Needs ◽

Care Needs ◽

Hospital Stays

Abstract This population-based retrospective cohort study examines the prevalence of hospital utilization during pregnancy and the primary reason for antenatal hospital utilization among women with intellectual and developmental disabilities (IDD). Massachusetts residents with in-state deliveries that were ≥ 20 weeks gestational age were included via data from the 2002-2009 Massachusetts Pregnancy to Early Life Longitudinal Data System. Among women with IDD, 54.8% had at least one emergency department (ED) visit during pregnancy, compared to 23% of women without IDD. Women with IDD were more likely to have an antenatal ED visit, observational stays, and non-delivery hospital stays. This study highlights the need for further understanding of the health care needs of women with IDD during pregnancy.

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Lessons Learned From Our Elders: How to Study Polypharmacy in Populations With Intellectual and Developmental Disabilities

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-52.1.60 ◽

2014 ◽

Vol 52 (1) ◽

pp. 60-77 ◽

Cited By ~ 23

Author(s):

Jessica N. Stortz ◽

Johanna K. Lake ◽

Virginie Cobigo ◽

Hélène M. J. Ouellette-Kuntz ◽

Yona Lunsky

Keyword(s):

Developmental Disabilities ◽

The Elderly ◽

Population Based ◽

Lessons Learned ◽

Future Research ◽

Intellectual And Developmental Disabilities ◽

Sampling Strategies ◽

Negative Consequences ◽

Concurrent Use ◽

Associated Variables

Abstract Polypharmacy is the concurrent use of multiple medications, including both psychotropic and non-psychotropic drugs. Although it may sometimes be clinically indicated, polypharmacy can have a number of negative consequences, including medication nonadherence, adverse drug reactions, and undesirable drug–drug interactions. The objective of this paper was to gain a better understanding of how to study polypharmacy among people with intellectual and developmental disabilities (IDD). To do this, we reviewed literature on polypharmacy among the elderly and people with IDD to inform future research approaches and methods on polypharmacy in people with IDD. Results identified significant variability in methods used to study polypharmacy, including definitions of polypharmacy, samples studied, analytic strategies, and variables included in the analyses. Four valuable methodological lessons to strengthen future polypharmacy research in individuals with IDD emerged. These included the use of consistent definitions of polypharmacy, the implementation of population-based sampling strategies, the development of clinical guidelines, and the importance of studying associated variables.

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Prevalence of intellectual and developmental disabilities among first generation adult newcomers, and the health and health service use of this group: A retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0215804 ◽

2019 ◽

Vol 14 (6) ◽

pp. e0215804 ◽

Cited By ~ 2

Author(s):

Anna Durbin ◽

James K. H. Jung ◽

Hannah Chung ◽

Elizabeth Lin ◽

Robert Balogh ◽

...

Keyword(s):

Cohort Study ◽

Developmental Disabilities ◽

Health Service ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

First Generation ◽

Service Use ◽

Health Service Use ◽

Intellectual And Developmental Disabilities ◽

Group A

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Postpartum emergency department use among women with intellectual and developmental disabilities: a retrospective cohort study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-211589 ◽

2019 ◽

Vol 73 (6) ◽

pp. 557-563 ◽

Cited By ~ 2

Author(s):

Monika Mitra ◽

Ilhom Akobirshoev ◽

Susan L Parish ◽

Anne Valentine ◽

Karen M Clements ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Emergency Department ◽

Developmental Disabilities ◽

Postpartum Period ◽

Post Partum ◽

Population Based ◽

Intellectual And Developmental Disabilities ◽

Healthcare Needs ◽

Ed Visits

BackgroundAn emerging body of evidence underscores the often-intensive perinatal healthcare needs of women with intellectual and developmental disabilities (IDD). However, population-based research examining postpartum experiences of US women with IDD is sparse. We examined emergency department (ED) use in the postpartum period among Massachusetts mothers with IDD.MethodsWe analysed 2002–2010 Massachusetts Pregnancy to Early Life Longitudinal data to compare any and ≥2 ED visits between mothers with and without IDD: within 1–42 days post partum, 1–90 days post partum and 1–365 days post partum. We also determined whether or not such ED use was non-urgent or primary-care sensitive.ResultsWe identified 776 births in women with IDD and 595 688 births in women without IDD. Across all three postpartum periods, women with IDD were vastly more likely to have any postpartum ED use, to have ≥2 ED visits and to have ED visits for mental health reasons. These findings persisted after controlling for numerous sociodemographic and clinical characteristics. Women with IDD were less likely to have non-urgent ED visits during the three postpartum periods and they were less likely to have primary-care sensitive ED visits during the postpartum period.ConclusionThese findings contribute to the emerging research on perinatal health and healthcare use among women with IDD. Further research examining potential mechanisms behind the observed ED visit use is warranted. High ED use for mental health reasons among women with IDD suggests that their mental health needs are not being adequately met.

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Contributions of Mental and Behavioral Health Conditions to Health Service Utilization Among People With Intellectual and Developmental Disabilities in Massachusetts

Inclusion ◽

10.1352/2326-6988-7.3.188 ◽

2019 ◽

Vol 7 (3) ◽

pp. 188-201 ◽

Cited By ~ 2

Author(s):

Emily Lauer ◽

Nassira D. Nicola ◽

Kimberley Warsett ◽

Rodrigo Monterrey

Keyword(s):

Developmental Disabilities ◽

Health Service ◽

Behavioral Health ◽

Service Utilization ◽

Health Service Utilization ◽

Population Based ◽

Health Conditions ◽

Intellectual And Developmental Disabilities ◽

Related Factors ◽

Inpatient Hospitalizations

Abstract Although existing evidence suggests an increased prevalence mental and behavioral health conditions for people with intellectual and developmental disabilities (IDD), little is known about health service utilization patterns related to these conditions. This study provides population-based data on hospital service utilization. Medicaid claims for people under 65 years of age in Massachusetts were used (years 2008-2013) to identify a cohort of people with IDD. Utilization of inpatient hospitalizations and outpatient Emergency Department (ED) was compared with the U.S. and MA general population through risk ratios. Findings suggest mental and behavioral health conditions were major contributors to increased utilization of inpatient and outpatient ED services and underscore the need for community-based service options that understand how to treat these conditions in people with IDD and address the myriad of related factors to identify, treat, and minimize the potential adverse life impact of these conditions for people with IDD.

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