Towards improved access to professional medication management for adults with intellectual disability and polypharmacy

BACKGROUND: People with intellectual disabilities (ID) suffer from special health problems and risks for diseases compared to the general population. Furthermore, they often have complex care needs, limited health literacy and polypharmacy occurs more frequently in their medication regimen. However, despite their special needs they often have limited access to health services. PURPOSE: The aim of the low-threshold intervention is that people with intellectual disabilities have, understand and adherently follow a medication plan that is integrated into their individual daily routine. This is intended to improve medication adherence and the reduction of medication complexity. APPROACH: The intervention consists of 1) two outreach home visits to the client, 2) continuous telephone contact, 3) case conference with an external multiprofessional team, 4) case review with the prescribing physicians. In close cooperation with the formal and informal care system as well as the prescribing physicians, the APNs analyze and reflect the different components of medication management and initiate changes to prescriptions where appropriate. They offer patient education and counseling concerning health literacy and medication adherence, and they actively involve the people with ID and their social environment. RESULTS: The impact of the presented complex intervention on medication adherence (primary outcome), medication complexity, use of psychotropics and quality of life (secondary outcomes) is currently evaluated in an RCT with N=202 in Germany. Furthermore, the evaluation design comprises qualitative stakeholder interviews and an inclusive research approach. Initial findings will be available mid-2020. Learning objectives: Get an impression of APN roles in intellectual disability nursing Learn about necessary skills and competencies APNs require for the presented interventions Learn about initial findings of the evaluation