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Sixty-five percent of individuals dually eligible for Medicare and Medicaid have two or more chronic conditions,1 and dually eligible individuals with disability in particular experience high rates of multiple chronic health conditions.2 In addition, individuals with intellectual and developmental disabilities (I/DD) are also diagnosed with multiple chronic conditions at high rates3 and typically prescribed more medications leading to a greater risk of polypharmacy, than the general population.4 Inappropriate polypharmacy is defined as the use of multiple medications in a way that is not deemed appropriate by clinical guidelines or an individual’s physician (e.g., treatment is not evidence-based or the risk of harm from treatments outweighs the benefits).5 Inappropriate polypharmacy can lead to negative health effects as an individual’s likelihood of experiencing an adverse drug event, medication nonadherence, and unwanted side effects increases with additional medications.6 Polypharmacy can also lead to medication contraindications and duplicate prescriptions, likely from seeing multiple physicians.7
In 2018, Partners Health Plan – a Medicare-Medicaid plan that serves members with IDD – began a Clinical Pharmacy Program to identify and address polypharmacy risks for their members when admitted to hospitals or skilled nursing facilities. Resources for Integrated Care invites you to explore the following spotlight on Partners Health Plan highlighting their Clinical Pharmacy Program and how it addresses polypharmacy in dually eligible individuals with I/DD.
The target audience for the Addressing Polypharmacy in Dually Eligible Individuals with I/DD: A Spotlight on Partners Health Plan product includes a wide range of stakeholders, including frontline workers; caregivers; staff at health plans, including Medicare-Medicaid Plans (MMPs), Dual Eligible Special Needs Plans (D-SNPs), and managed LTSS plans; and other health care and community-based organizations who are interested in strategies for supporting provides that serve individuals with I/DD.
1Fox, M. H., & Reichard, A. (2013). Disability, health, and multiple chronic conditions among people eligible for both Medicare and Medicaid, 2005-2010. Preventing Chronic Disease, 10, E157. https://doi.org/10.5888/pcd10.130064.
2Ibid.
3Nabhanizadeh, A., Oppewal, A., Boot, F. H., & Maes-Festen, D. (2019). Effectiveness of medication reviews in identifying and reducing medication-related problems among people with intellectual disabilities: A systematic review. Journal of Applied Research in Intellectual Disabilities: JARID, 32(4), 750–761. https://doi.org/10.1111/jar.12580.
4Nabhanizadeh, A., Oppewal, A., Boot, F. H., & Maes-Festen, D. (2019).
5Duerden, M., Avery, T., & Payne, R. (2013). Polypharmacy and medicines optimisation: Making it safe and sound. The King’s Fund. Available at: kingsfund.org.uk/publications/polypharmacy-and-medicines-optimisation.
6Legislative Analysis and Public Policy Association. (2021). Polypharmacy and the elderly: Reducing the risk of adverse events through monitoring and communication. Retrieved from http://legislativeanalysis.org/wp-content/uploads/2021/01/Polypharmacy-FINAL.pdf.
7Ibid.