MDisability researchers study efficacy of comprehensive medication reviews for people with intellectual and developmental disabilities

Many people with intellectual and developmental disabilities (IDD) take multiple medications — also known as polypharmacy. Taking numerous medications can increase the risk of side effects, drug interactions, and challenges in keeping track of what to take and when. These risks pose a particular problem for people with IDD and their caregivers.

Comprehensive Medication Reviews (CMR) have been shown to help people in many different groups, although they haven’t been widely used for people with IDD.

“There is a concerning lack of data and approaches on how we can help people with IDD safely manage multiple medications,” said MDisability Director Michael M. McKee, MD, MPH. “I wanted to draw upon the expertise of specialists within the Department of Family Medicine and the College of Pharmacy -- as well as specialists affiliated with MDisability -- who have done comprehensive medication reviews for other patient populations to determine how we can adapt those processes for people with IDD in family medicine settings.”

MDisability researchers have published results of their work with their paper, “Comprehensive medication reviews for adults with intellectual or developmental disabilities,” in the Journal of the American College of Clinical Pharmacy. 

First author is Steven R. Erickson, PharmD, of the College of Pharmacy at U-M, pictured left. Other MDisability-associated authors include Ariana Nigoghosian (a former 2023 summer intern and current U-M Medical School student); Brianna Marzolf, DO, former Disability Health Fellow, now clinical assistant professor at the Department of Family and Community Medicine at University of Cincinnati; MDisability Manager Dawn Michael, Muhammad Othman (former 2024 summer intern); and senior author McKee. Additionally, U-M statistician Beatrice Palazzolo assisted with the research. 

The study’s goal was to determine if CMRs could help adults with IDD who live in community group homes. The study had three main parts: first, a clinical pharmacist held CMR sessions with patients and their caregivers (almost all virtually); second, researchers counted medication-related problems (MRPs) before and after the CMR; and third, they interviewed caregivers and healthcare providers to determine how satisfied they were with the process. 

Twenty-nine people with IDD and their caregivers took part in the study. Most participants were non-Hispanic White, and the most common diagnoses were intellectual disability, autism spectrum disorder, Down syndrome, cerebral palsy, and fetal alcohol syndrome. 

On average, each patient had about four medication-related problems. The most common issue was an inaccurate medication list in the health systems’ medical records. For example, sometimes medicines or directions on how to take medications were missing, or there was no explanation for why a medicine was prescribed. Other problems included duplicate therapies and the need for better monitoring, such as checking blood sugar or blood pressure at home.

Pharmacists shared 69 recommendations for fixing these problems with the patients’ primary care doctors. Doctors accepted 49 of these suggestions, indicating that the CMRs can create real changes in care. 

Caregivers were also asked how they felt about the CMR process. Out of 21 participants, 12 completed a satisfaction survey. The average satisfaction score was 4.9 out of 5. Caregivers said the CMR was valuable and useful, and they appreciated the extra attention for the person under their care. 

Next steps include implementation of a CMR program on a larger scale and conducting outcomes assessment, with the goal of ensuring the safe and effective use of medications by patients who have IDD.  

Authors also recommend further research, with larger and more diverse groups to determine if CMRs might help more people with IDD in different settings. 

“This study suggests that CMRs can be a helpful way to identify and correct medication problems for people with IDD living in group homes,” said first author Erickson. “Through collaboration, patients, caregivers, pharmacists, and doctors can serve as an effective team to increase medication safety and the quality of care for people with IDD.”

Article cited: Erickson, S. R., Nigoghosian, A., Marzolf, B., Palazzolo, B., Michael, D., Othman, M., & McKee, M. M. (2025). Comprehensive medication reviews for adults with intellectual or developmental disabilities. JACCP:  Journal of the American College of Clinical Pharmacy. https://doi.org/10.1002/jac5.70120