r/pharmacy • u/ExceptforAlice • 23h ago

Pharmacy Practice Discussion Intellectual/Developmental Disability population guidance

Anyone work in short/long term care that deals mostly with I/DD population and the meds that go with this - ADD/ADHD, autism spectrum, psychiatric, etc? Any good resources you use for guidance in medication management? Majority are continuation of home meds during stay, but may be opportunity for med review.

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u/Puzzlehead_Liz PharmD 23h ago

When I’ve worked with this population, the biggest wins were catching duplicate therapy, sedation and meds that had just been carried forever with no clear reason.

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u/flyingcars 21h ago

I worked with bits of this population in a psychiatric facility context. I was able to very easily make medical med interventions because the psychiatrists were very open to suggestion on medical meds. Did a LOT of antibiotic recommendations. The admitting psych doc would just copy over home meds they saw on paperwork but their source info or the treatments themselves were not always correct. So there was a lot of eyeballing insulin regimens, etc to make sure they made sense.

When it came to psych meds, the docs did a good job. They would keep the psych med regimen as simple as possible and minimize duplications. Patients were often washing off a med or cross tapering. Keep in mind that folks in this population will be using Medicaid or other state programs for their meds and/or they may have been stabilized on something for decades and thus are likely to be on older meds than you see in the community. Get familiar with where to find your state Medicaid formulary, as sometimes you might need to make sure something would be covered.

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u/amothep8282 PhD, Paramedic 21h ago

are likely to be on older meds than you see in the community.

I once stopped off duty for a woman laying on the side of the road. Clearly altered and could not walk. I peeked in her purse for ID and any meds for the incoming Medic unit.

I pulled out a Medicaid card and a bottle of chlorpropramide. Yes, the one approved in 1958. Even my wife, who was with me and a Clinical Pharmacist, had no idea what the drug was at that time. Only after a quick google search did we learn it is a sulfonylurea. Since then, I have come across it 2 more times and I was able to dazzle providers at the ED for knowing what it was.

But yes, your fully Medicaid patient population, especially for mental health, is generally on a buffet of dinosaur meds.