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Psychotropic medication use and obesity among IDD service recipients in 15 states

Psychotropic medication use and obesity among IDD service recipients in 15 states. WHAT IS NCI?.

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Psychotropic medication use and obesity among IDD service recipients in 15 states

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  1. Psychotropic medication use and obesity among IDD service recipients in 15 states

  2. WHAT IS NCI? Multi-state collaboration of state DD agencies interested in measuring how well public systems for people with developmental disabilities perform along several areas, including: employment, community inclusion, choice, rights, and health and sa Launched in 1997 in 13 participating states Supported by participating states NASDDDS – HSRI Collaboration NCI

  3. WHAT IS NCI? • Adult Consumer Survey • Family Survey • Adult Family Survey (person lives at home; 18 and older) • Family Guardian Survey (person lives out-of-home; 18 and older) • Children Family Survey (child lives at home; under 18 years old) • Provider Survey • Staff Stability • System Data • Mortality • Incidents NCI

  4. WHAT IS NCI?Adult Consumer Survey Standardized, face-to-face interview with a sample of individuals receiving services No pre-screening procedures Conducted with adults only (18 and over) receiving at least one service besides case management Takes 50 minutes on average Background section filled out by case managers and workers NCI

  5. DATA Adult Consumer Survey, background section 2010-2011 data collection cycle 8,796 individuals 15 states NCI

  6. FINDINGSDemographics Gender Where people live: 56% 44% Average Age: 42.5 yrs NCI

  7. FINDINGS Demographics Race and Ethnicity NCI

  8. FINDINGS Demographics Level of ID Other Diagnoses NCI

  9. FINDINGS Medications Takes medications for mood disorders: 38% Takes medications for anxiety: 29% Takes medications for behavior problems: 25% Takes medications for psychotic disorders: 18% Takes medications for at least one of the above: 53% NCI

  10. FINDINGS Medications N = 3,977 Note: this is not the same as the number of medications taken. A person may take one medication for more than one purpose/condition. Of those who take medications for at least one condition/purpose, how many take meds for 1, 2, 3 and all 4 of them? NCI

  11. FINDINGS Medications and mental illness 49% of people who need support for behavior issues take meds for behavior problems Only 8% of people who do not need support for behavior issues take meds for behavior problems 88% of people with MI or a psychiatric disorder take meds for mood, anxiety, or psychotic disorders BUT 31% of people not diagnosedwith MI or a psychiatric disorder also take meds for mood, anxiety, or psychotic disorders Meds for mood or anxiety disorder are more common w/o an MI dx than meds for psychotic disorder NCI

  12. FINDINGSCharacteristics of people who take meds Age At least one med: 43.3 years No meds: 41.5 years Diagnoses ASD CP Down Syndrome At least one med: 13% 10% 5% No meds: 6% 20% 13% Place of residence InstitutionGroup home Indep home/apt Parent’s At least one med: 6% 35% 18% 22% No meds: 6% 19% 17% 47% NCI

  13. FINDINGSObesity and medications Weight Weight and meds 62% overweight or obese No meds: 57% overweight or obese At least one med: 67% overweight or obese Odds ratio: 1.49 (p<0.001) NCI

  14. FINDINGS Obesity and medications BUT, personal characteristics (diagnoses, age, mobility) and place of residence may also affect weight, AND, may be related to whether a person is taking medications, SO, need risk-adjustment NCI

  15. FINDINGS Obesity and medications • Logistic regression • Dependent variable: overweight or obese • Independent variable: takes at least one med • Controlling for: mobility, residence type, dx of ASD, dx of CP, dx of Down Syndrome, age • All control variables are significant at 0.01 level • After risk-adjustment: Odds ratio = 1.44 (p-value < 0.001) NCI

  16. CONCLUSIONS 53% take at least one medication for mood/anxiety/behavior/psychotic disorders High percentage of people without an MI diagnosis still take these meds Those who take meds are more likely to live in group homes and less likely to live with parents or relatives Those who take meds are more likely to be diagnosed with ASD and less likely to be diagnosed with CP or Down Syndrome NCI

  17. CONCLUSIONS 62% of people in the study are overweight or obese People who take at least one med are more likely to be overweight or obese This persists even after controlling for personal characteristics and place of residence (odds ratio of 1.44) NCI

  18. CONTACT www.NationalCoreIndicators.org www.HSRI.org www.NASDDDS.org NCI

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