Psychotropic medication use and obesity among IDD
Description: Psychotropic medication use and obesity among IDD service recipients in 15 states AAIDD 2012, 6192012 WHAT IS NCI? Multi-state collaboration of state DD agencies interested in measuring how well public systems for people with
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slide1. Psychotropic medication use and obesity among IDD service recipients in 15 states AAIDD 2012, 6/19/2012<br>
slide2. 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 2<br>
slide3. 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 3 NCI<br>
slide4. 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 4 NCI<br>
slide5. DATA Adult Consumer Survey, background section
2010-2011 data collection cycle
8,796 individuals
15 states 5 NCI<br>
slide6. FINDINGS Demographics 6 NCI 56% 44% Gender Average Age: 42.5 yrs Where people live:<br>
slide7. FINDINGS Demographics 7 NCI Race and Ethnicity<br>
slide8. FINDINGS Demographics 8 NCI Level of ID Other Diagnoses<br>
slide9. 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% 9 NCI<br>
slide10. FINDINGS Medications Of those who take medications for at least one condition/purpose, how many take meds for 1, 2, 3 and all 4 of them? 10 NCI 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.<br>
slide11. 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 diagnosed with 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 11 NCI<br>
slide12. FINDINGS Characteristics of people who take meds 12 NCI 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 Institution Group home Indep home/apt Parent’s
At least one med: 6% 35% 18% 22%
No meds: 6% 19% 17% 47%<br>
slide13. FINDINGS Obesity and medications 13 NCI 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)<br>
slide14. 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 14 NCI<br>
slide15. 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) 15 NCI<br>
slide16. 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 16 NCI<br>
slide17. 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) 17 NCI<br>
slide18. CONTACT www.NationalCoreIndicators.org
www.HSRI.org
www.NASDDDS.org 18 NCI<br>
slide2. 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 2<br>
slide3. 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 3 NCI<br>
slide4. 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 4 NCI<br>
slide5. DATA Adult Consumer Survey, background section
2010-2011 data collection cycle
8,796 individuals
15 states 5 NCI<br>
slide6. FINDINGS Demographics 6 NCI 56% 44% Gender Average Age: 42.5 yrs Where people live:<br>
slide7. FINDINGS Demographics 7 NCI Race and Ethnicity<br>
slide8. FINDINGS Demographics 8 NCI Level of ID Other Diagnoses<br>
slide9. 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% 9 NCI<br>
slide10. FINDINGS Medications Of those who take medications for at least one condition/purpose, how many take meds for 1, 2, 3 and all 4 of them? 10 NCI 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.<br>
slide11. 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 diagnosed with 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 11 NCI<br>
slide12. FINDINGS Characteristics of people who take meds 12 NCI 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 Institution Group home Indep home/apt Parent’s
At least one med: 6% 35% 18% 22%
No meds: 6% 19% 17% 47%<br>
slide13. FINDINGS Obesity and medications 13 NCI 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)<br>
slide14. 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 14 NCI<br>
slide15. 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) 15 NCI<br>
slide16. 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 16 NCI<br>
slide17. 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) 17 NCI<br>
slide18. CONTACT www.NationalCoreIndicators.org
www.HSRI.org
www.NASDDDS.org 18 NCI<br>