Mirror, mirror on the wall: is CompEx the fairest endpoint of all?

ERJ Open Research · 2026-01-01

<title>Extract</title> Preventing exacerbations is a key goal in asthma management [1]. Over the decades, novel asthma biologics have been approved to reduce the risk of exacerbation in patients with severe or uncontrolled asthma [1, 2]. Clinical trials have traditionally relied on severe exacerbation (SevEx) as the primary endpoint [3]. SevEx is typically defined as events that require systemic corticosteroids, asthma-related hospitalisations, or emergency department visits due to asthma requiring systemic corticosteroids [1, 3]. However, using SevEx as the sole endpoint may overlook subtler but impactful worsening events that patients experience daily [3]. Therefore, extending beyond SevEx as a single endpoint is important to facilitate the development of new therapies.

Opportunity awaits: Comprehensive medication management for adults with developmental disabilities living in the community

Journal of the American Pharmacists Association · 2026-02-14

Emergency Department Visits for Adverse Medication Events for Adults With Intellectual or Developmental Disabilities

Annals of Pharmacotherapy · 2026-04-23

BACKGROUND: Persons with intellectual or developmental disabilities (IDD) are at risk of adverse medication events (AMEs). Polypharmacy, complex medication regimens, and reliance on others to manage medications are a few risk factors that are more common in this group of patients than in the general population. OBJECTIVE: To determine the likelihood that an emergency department (ED) visit for an AME is greater for adults with IDD than for the general adult population. METHODS: This exploratory study used the 2018 National (Nationwide) Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project (HCUP) databases and applied a multivariable logistic regression analysis for complex surveys to determine the likelihood that an ED visit was for an AME and was different for adults with IDD compared to those without IDD, controlling for patient characteristics. RESULTS: A greater proportion of ED visits for adult patients with IDD were for AMEs (4.4%) compared to patients without IDD (2.6%). The unadjusted odds ratio for IDD when compared with non-IDD was 1.695, with a 95% confidence interval of 1.649 to 1.743. In the multivariable logistic regression model, the odds ratio associated with a patient with IDD was 1.795 (95% confidence interval 1.75, 1.84), indicating that the ED admission was significantly more likely to be due to an AME for patients with IDD compared to patients without IDD. CONCLUSION AND RELEVANCE: Adults with IDD have a higher likelihood that an ED visit is due to an AME compared with the general population. Knowing this, clinicians and researchers can begin to investigate the reasons for this disparity, in an effort to ensure the safe and effective use of medications by persons with IDD.

Comprehensive Medication Reviews for Adults With Intellectual or Developmental Disabilities

JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · 2025-09-20 · 1 citations

ABSTRACT Introduction People with intellectual or developmental disabilities face an elevated risk of adverse medication and health outcomes due to polypharmacy, medication interactions, and adherence issues. This study's objective was to assess the feasibility of virtual and in‐home comprehensive medication reviews (CMRs) to identify and, when necessary, intervene on medication‐related problems (MRPs) among patients with intellectual or developmental disabilities (IDD) residing in community group homes and to assess the caregivers' satisfaction with the CMRs. Methods Patients with IDD taking 5 or more medications were detected by using the health system's data warehouse. CMR steps included meeting with the patient and caregiver, assessing for MRP using the American Pharmacist Association/National Association of Chain Drug Stores framework, and providing a summary report for the patient/caregiver/prescriber. The report was reviewed with the caregiver 2 weeks after the initial CMR visit and sent to the prescriber. Outcomes measured included changes in the number of medications in patients' regimens, the number of MRPs identified, and a description of the MRPs. Results Twenty‐nine patients with IDD received the CMR intervention. A median and interquartile range (IQR) of 4 (3.0, 4.0) MRPs were identified for each patient. The most common MRPs were inaccurate medication list in the medical record ( n = 21), duplication of therapy ( n = 13), no indication for medication use documented ( n = 8), and a potential problem present but not treated ( n = 7). There was a statistically significant difference in the median number of medications prior to and after CMR ( p = 0.046), which decreased from 16 (12, 19) to 14.5 (10.8, 18.3). Caregivers were highly satisfied with the CMR process. Conclusion These results support the feasibility of conducting CMR both virtually and in‐home. Implementation of a CMR program on a larger scale and conducting outcomes assessment are the next steps, with the goal to ensure safe and effective use of their medications by patients who have IDD.

Individual and Environmental Factors Associated With Polypsychotropic Medication Regimens Among Adults With Intellectual Disability

American Journal on Intellectual and Developmental Disabilities · 2025-06-25 · 1 citations

Polypharmacy, the concurrent use of multiple medications, is common among adults with intellectual disability. Psychotropic medications are often implicated in polypharmacy among this population. The current study aimed to determine individual and environmental factors associated with polypsychotropic medication regimens using a population-based sample of adults with intellectual disability who receive Home and Community-Based Services waivers in Oklahoma. The following questions guided the study: a) What is the prevalence of polypsychotropic medication regimens? b) What are the individual and environmental factors significantly associated with polypsychotropic medication regimens? Findings confirmed high prevalence rates of polypsychotropic medication regimens among adult participants and highlighted significant associated individual and environmental factors.

Framework for an interprofessional experience addressing health and disability for health professional students

Currents in Pharmacy Teaching and Learning · 2024-04-02 · 3 citations

Opioid prescription patterns among commercially insured children with and without cerebral palsy

Journal of Pediatric Rehabilitation Medicine · 2024-03-15 · 2 citations

PURPOSE: This study aimed to describe opioid prescription patterns for children with vs. without cerebral palsy (CP). METHODS: This cohort study used commercial claims from 01/01/2015-12/31/2016 and included children aged 2-18 years old with and without CP. Opioid prescription patterns (proportion exposed, number of days supplied) were described. A zero-inflated generalized linear model compared the proportion exposed to opioids in the follow-up year (2016) and, among those exposed, the number of days supplied opioids between cohorts before and after adjusting for age, gender, race, U.S. region of residence, and the number of co-occurring neurological/neurodevelopmental disabilities (NDDs). RESULTS: A higher proportion of children with (n = 1,966) vs. without (n = 1,219,399) CP were exposed to opioids (12.1% vs. 5.3%), even among the youngest age group (2-4 years: 9.6% vs. 1.8%), and had a greater number of days supplied (median [interquartile range], 8 [5-13] vs. 6 [4-9] days; P < 0.05). Comparing children with opioid exposure with vs. without CP, a greater number of days supplied was identified for older age, Asian race/ethnicity, and without co-occurring NDDs, and a lower number of days supplied was observed for Black race/ethnicity and with ≥1 co-occurring NDDs. CONCLUSION: Children with CP are more likely to be exposed to opioids and have a higher number of days supplied.

Cost-related non-adherence to medications among adults with asthma in the USA, 2011–2022

Thorax · 2024-12-09 · 6 citations

BACKGROUND: Uncontrolled asthma is possibly caused by medication non-adherence, and financial hardship can be a major contributor to non-adherence. Since economic conditions and asthma management have changed over time, a comprehensive investigation of cost-related medication non-adherence (CRN) among adults with asthma is crucial. OBJECTIVE: To evaluate trends, prevalence and determinants of CRN, and its impact on asthma control among US adults with asthma. METHODS: Data from 2011 to 2022 National Health Interview Survey were used. Joinpoint regression analysis was used to evaluate trends in the prevalence of CRN. A multivariable logistic regression model was used to identify factors associated with CRN. Two additional multivariable logistic regression models were used to examine associations between CRN and asthma-related adverse events, including asthma attacks and emergency room (ER) visits for asthma. RESULTS: A total of 30 793 adults with asthma were included, representing 8.1% (19.38 million) of the US population. From 2011 to 2022, a declining trend in the prevalence of CRN among US adults with asthma was observed. Approximately every one in six adults with asthma was non-adherent to medications due to cost. Several factors, including demographics and comorbidities, were associated with CRN. Adults with asthma who had CRN were at an increased risk of experiencing asthma attacks (adjusted OR, 1.95; 95% CI 1.78 to 2.13) and ER visits for asthma (adjusted OR, 1.63; 95% CI 1.44 to 1.84). CONCLUSION: Since asthma is one of the leading chronic diseases, the burden of cost-related non-adherence to medications highlights the need for appropriate policies and social supports to address such problems.

High cardiorespiratory disease burden following a fracture among adults with intellectual disabilities

Bone · 2023-04-28 · 1 citations

Heart rate and autonomic biomarkers distinguish convulsive epileptic vs. functional or dissociative seizures

Seizure · 2023-08-26 · 2 citations