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  • Title: A national study of prescribed drugs in institutions and community residential facilities for mentally retarded people.
    Author: Hill BK, Balow EA, Bruininks RH.
    Journal: Psychopharmacol Bull; 1985; 21(2):279-84. PubMed ID: 4001292.
    Abstract:
    The prevalence of psychotropic and nonpsychotropic drug prescriptions in institutions and community residential facilities in 1978-79 was assessed. The data were gathered as an incidental part of a comprehensive national interview study of the characteristics of residential facilities and their residents. The study included 2271 retarded individuals in 236 residential facilities in the US. Facilities were selected through a 2-stage probability sample design in such a way that the probability of a facility's selection was proportionate to its size (number of residents) and so that the distribution of sample facilities across census regions and size classes was in close agreement with the distribution of facilities nationally. Interviews at 75 institutions and 161 private facilities were conducted between September 1978 and April 1979. Demographic information about individual residents, including date of birth, date of admission, previous type of residential placement, age, height, weight, diagnosed degree of retardation, and diagnosis of epilepsy, autism, or mental illness, was obtained from each resident's records. The staff person most familiar with each resident was then identified and interviewed about the resident. Care persons were asked whether and for what purpose drugs were prescribed for each resident. 75.8% of institutionalized residents and 54.3% of community facility residents were reported to be receiving at least 1 type of regularly prescribed medication. Percentages reported for specific drugs should be considered minimums, because drug names were not always elicited if the drug's purpose was known. Drugs not named, but reported to be prescribed for a chronic health condition, epilepsy, a psychiatric problem, for sleeping, or for birth control, were listed with "other" within tentative categories. Multiple regression was used to examine the relationships among drug use and several resident and facility characteristics. The institutionalized and community-based samples were combined for these analyses. Drugs reported to be prescribed for chronic health problems most frequently were used by older, nonambulatory residents who had health problems. Use of antiepilepsy drugs was most closely associated with a history of seizures. Only 1.3% of community facility residents and 1.6% of institutionalized residents whose records did not document epilepsy were reported to be receiving antiepilepsy drugs. Psychotropic drugs most often were prescribed for residents with behavior problems or for those with a recorded mention of mental illness or autism. Older, heavier, and more severely retarded residents also were more likely to receive psychotropic drugs. Contraceptive drugs were predicted by age, sex, ability, and minority status. Younger and less retarded women were more likely to receive birth control methods, as were minorities.
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