Emergency Department Visits for Adverse Medication Events for Adults With Intellectual or Developmental Disabilities

Abstract

Background:

Persons with intellectual or developmental disabilities (IDD) are at risk of adverse medication events (AMEs). Polypharmacy, complex medication regimens, and reliance on others to manage medications are a few risk factors that are more common in this group of patients than in the general population.

Objective:

To determine the likelihood that an emergency department (ED) visit for an AME is greater for adults with IDD than for the general adult population.

Methods:

This exploratory study used the 2018 National (Nationwide) Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project (HCUP) databases and applied a multivariable logistic regression analysis for complex surveys to determine the likelihood that an ED visit was for an AME and was different for adults with IDD compared to those without IDD, controlling for patient characteristics.

Results:

A greater proportion of ED visits for adult patients with IDD were for AMEs (4.4%) compared to patients without IDD (2.6%). The unadjusted odds ratio for IDD when compared with non-IDD was 1.695, with a 95% confidence interval of 1.649 to 1.743. In the multivariable logistic regression model, the odds ratio associated with a patient with IDD was 1.795 (95% confidence interval 1.75, 1.84), indicating that the ED admission was significantly more likely to be due to an AME for patients with IDD compared to patients without IDD.

Conclusion and Relevance:

Adults with IDD have a higher likelihood that an ED visit is due to an AME compared with the general population. Knowing this, clinicians and researchers can begin to investigate the reasons for this disparity, in an effort to ensure the safe and effective use of medications by persons with IDD.