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Research

Primary care for people with an intellectual disability — what is prescribed? An analysis of medication recommendations from the BEACH dataset

Carmela Salomon, Helena Britt, Allan Pollack and Julian Trollor
BJGP Open 2018; 2 (2): bjgpopen18X101541. DOI: https://doi.org/10.3399/bjgpopen18X101541
Carmela Salomon
1 Postdoctoral Project Officer, Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, , Australia
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Helena Britt
2 Professor of Primary Care Research and Director, Family Medicine Research Centre, School of Public Health, Faculty of Medicine, University of Sydney, , Australia
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Allan Pollack
3 Research Analyst, Family Medicine Research Centre, School of Public Health, Faculty of Medicine, University of Sydney, , Australia
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Julian Trollor
4 Chair of Intellectual Disability Mental Health and Head of Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, , Australia
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  • For correspondence: j.trollor@unsw.edu.au
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Abstract

Background People with intellectual disability (ID) experience a range of health disparities. Little is known about differential primary care prescribing patterns for people with and without ID.

Aim To compare medications recommended by GPs at encounters where ID is recorded versus other encounters.

Design & setting Analysis of national Australian GP medication data from the Bettering the Evaluation and Care of Health (BEACH) programme, January 2003–December 2012 inclusive.

Method Medication recommendations made at encounters where an ID-defining problem was recorded as a reason for encounter (RFE) and/or as a problem managed, were allocated to the ‘ID group’ (n = 563). These encounters were compared with all other encounters (the ‘non-ID group’, n = 1 004 095) during the study period. Following age–sex standardisation of ID group encounters, significant differences were determined by non-overlapping 95% confidence intervals (CIs).

Results Antipsychotics and anticonvulsants were recommended more frequently at ID group encounters than at non-ID group encounters. Antidepressant and anxiolytic recommendation rates did not differ between groups. Narcotic analgesic and antihypertensive recommendations were significantly lower at ID group encounters.

Conclusion Higher rates of epilepsy and mental illness, and off-label use of some antipsychotics and anticonvulsants for behaviour management in people with ID, may have contributed to medication recommendations observed in this analysis. Lower narcotic analgesic recommendations at ID group encounters may relate to complex presentations and the nature of problems managed, while lower antihypertensive recommendations may indicate some potential omission of routine blood pressure measurement.

  • intellectual disability
  • general practice
  • prescriptions
  • psychotropic drugs
  • narcotics
  • antihypertensive agents
  • Received February 5, 2018.
  • Accepted February 12, 2018.
  • Copyright © The Authors 2018

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Primary care for people with an intellectual disability — what is prescribed? An analysis of medication recommendations from the BEACH dataset
Carmela Salomon, Helena Britt, Allan Pollack, Julian Trollor
BJGP Open 2018; 2 (2): bjgpopen18X101541. DOI: 10.3399/bjgpopen18X101541

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Primary care for people with an intellectual disability — what is prescribed? An analysis of medication recommendations from the BEACH dataset
Carmela Salomon, Helena Britt, Allan Pollack, Julian Trollor
BJGP Open 2018; 2 (2): bjgpopen18X101541. DOI: 10.3399/bjgpopen18X101541
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Keywords

  • intellectual disability
  • General practice
  • prescriptions
  • psychotropic drugs
  • narcotics
  • antihypertensive agents

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