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Laxative use among older adults with intellectual disability: a cross-sectional observational study

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Abstract

Background: Chronic constipation is a prevalent issue in older people with intellectual disabilities and may have a significant negative impact on quality of life. The use of laxatives have not been adequately studied in this population. Objective: To examine laxatives in relation to prevalence, pattern, dosage, reported indication and correlates. Setting: Older people with intellectual disabilities who live independently, in community group homes or residential care in Ireland. Method: Data was extracted from wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). Descriptive statistics, bivariate analyses and multiple logistic regression were carried out. Laxative use was analysed using two indicators for chronic constipation, reported doctor’s diagnosis of constipation and Rome III criteria. Main outcome measure: Laxative use. Results: Among the cohort n = 677, chronic constipation was reported by 38.5% (n = 257). In total 41.5% (n = 281) reported 431 laxatives (mean ± 1.53 ± 0.74), with 74.3% (n = 209) of those with laxative use reporting chronic constipation. There were 40% (n = 113) who took 2 + laxatives, within which, 60% (n = 67) were using a combination from same laxative class. Reporting chronic constipation, living in residential care, exposure to anticholinergics and receiving soft/liquidized food were significantly associated with laxative use. Conclusion: Chronic constipation and laxative use were highly prevalent in this study of older adults with intellectual disabilities. The treatment of constipation appeared to be unsystematic. Intra-class laxative use was frequent. There is a need for evidence-based treatment guidelines developed especially for people with intellectual disabilities to provide effective, quality care.

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Acknowledgements

The authors would like to thank the people with ID who participated in this study, their families, the services provider, and the IDS-TILDA team for their support. They would also like to acknowledge funding for the IDS-TILDA study from the Health Research Board (HRB) which is managed by the Department of Health in Ireland. The Authors would like to acknowledge Anne Belton (A.B.) for her assistance in data coding and checking.

Funding

The IDS-TILDA study is funded by the Department of Health and managed by the Health Research Board in Ireland. The lead author (H.ALM.) received funding for the PhD from the Saudi Ministry of Education. The funding bodies have no influence in the study design or in writing of the manuscript.

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Authors and Affiliations

  1. School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin 2, Ireland

    Hadiah AlMutairi, Máire O’Dwyer & Martin C. Henman

  2. IDS-TILDA, School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland

    Hadiah AlMutairi & Elish Burke

  3. Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland

    Mary McCarron

  4. School of Social Work, Temple University, Philadelphia, PA, USA

    Philip McCallion

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  1. Hadiah AlMutairi
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Correspondence to Hadiah AlMutairi.

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Hadiah AlMutairi, Máire O’Dwyer, Elish Burke, Mary McCarron, Philip McCallion and Martin C Henman declare that they have no conflicts of interest.

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AlMutairi, H., O’Dwyer, M., Burke, E. et al. Laxative use among older adults with intellectual disability: a cross-sectional observational study. Int J Clin Pharm 42, 89–99 (2020). https://doi.org/10.1007/s11096-019-00942-z

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