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Structured Medication Review and Shared Decision-Making in Patients with Mild Intellectual Disabilities Who Use

Gerda de Kuijper1, Josien Jonker1, Rien Hoge2

  • 1Mental Healthcare Drenthe, Department Centre for Intellectual Disability and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands.

Pharmacy (Basel, Switzerland)
|January 21, 2026
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Summary

Structured medication reviews with accessible information improved medication appropriateness and shared decision-making for adults with intellectual disabilities. This approach addressed medication problems and enhanced patient-clinician collaboration.

Keywords:
accessible medication leafletsintellectual disabilitiesmedication reviewmental healthpsychotropic medicationshared decision-making

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Area of Science:

  • Pharmacology
  • Intellectual Disabilities
  • Health Services Research

Background:

  • Individuals with intellectual disabilities often use multiple medications, sometimes inappropriately.
  • Accessible information is crucial for promoting shared decision-making regarding medication.
  • Psychotropic medication use is common in this population, necessitating careful management.

Purpose of the Study:

  • To assess medication appropriateness and shared decision-making in adults with mild intellectual disabilities using psychotropic medication.
  • To evaluate the impact of a structured, multidisciplinary medication review intervention.
  • To combine data from two intervention studies conducted in different settings.

Main Methods:

  • Combined data from two intervention studies involving adults with mild intellectual disabilities.
  • Intervention included structured, multidisciplinary medication reviews and accessible medication leaflets.
  • Outcomes measured: medication use, pharmacotherapeutic problems, recommendation implementation, and shared decision-making (using the Shared Decision-Making Questionnaire Q9).

Main Results:

  • Participants used an average of nearly seven medications, primarily neurotropic, gastrointestinal, cardiovascular, and respiratory agents.
  • An average of two pharmacotherapeutic problems were identified per participant (e.g., overtreatment, side effects).
  • Approximately 75% of recommendations (e.g., dose reduction) were implemented; high satisfaction with shared decision-making was reported.

Conclusions:

  • Multidisciplinary medication reviews with accessible leaflets may improve appropriate medication use and shared decision-making.
  • The intervention demonstrated potential in identifying and addressing medication-related issues.
  • Further research is needed to confirm these findings and optimize the intervention.