Psychotropic
medication use and
obesity among IDD
service recipients in
15 states
AAIDD 2012, 6/19/2012
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
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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
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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
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DATA
•
•
•
•
Adult Consumer Survey, background section
2010-2011 data collection cycle
8,796 individuals
15 states
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FINDINGS
Demographics
Gender
Where people live:
56%
44%
Average Age: 42.5 yrs
0%
5%
10%
20%
35%
4%
17%
Independent Home/ Apt
34%
Parent or Relative's home
6%
Foster care/ Host home
1%
4%
Other
Don't know
30%
27%
Group Home
Nursing Facility
25%
6%
Specialized Institutional facility
Apartment Program
NCI
15%
0%
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FINDINGS
Demographics
Race and Ethnicity
1% 3%
1% 3%
White
19%
77%
Black or African
American
Hispanic
Asian
Non-Hispanic
Don't Know
Other race not listed
96%
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FINDINGS
Demographics
Level of ID
7% 4%
No ID label
12%
36%
14%
Moderate
Severe
27%
Other Diagnoses
Mild
Profound
Don't know
35%
33%
30%
26%
23%
25%
20%
15%
15%
11% 10%
10%
10%
5%
3%
9%
8%
2%
1%
0%
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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%
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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?
14%
18%
39%
1 purpose
2 purposes
29%
3 purposes
4 purposes
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.
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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
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FINDINGS
Characteristics of people who take meds
Age
At least one med: 43.3 years
No meds:
41.5 years
Diagnoses
At least one med:
No meds:
ASD
13%
6%
CP
10%
20%
Down Syndrome
5%
13%
Place of residence
At least one med:
No meds:
NCI
Institution
6%
6%
Group home
35%
19%
Indep home/apt
18%
17%
Parent’s
22%
47%
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FINDINGS
Obesity and medications
Weight
33%
6%
Weight and meds
underweight
32%
29%
normal
overweight
35%
obese
30%
37%
35%
40%
29%
28%
29%30%
underweight
25%
normal
20%
62% overweight or obese
15%
10%
overweight
8%
5%
obese
4%
0%
no meds
at least one kind
No meds:
57% overweight or obese
At least one med: 67% overweight or obese
Odds ratio:
1.49 (p<0.001)
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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
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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)
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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
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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)
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CONTACT
www.NationalCoreIndicators.org
www.HSRI.org
www.NASDDDS.org
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