July TCAID: In Focus - Introduction to the Medicines Optimization and Innovation theme, TCAID

Polypharmacy, the use of multiple medicines, has been an identified issue for people with intellectual disability since the inception of IDS-TILDA. The study has revealed that individuals with intellectual disability are more likely to experience polypharmacy with 35% taking between 5-9 medicines (polypharmacy) and over 21% taking 10+ medicines this compares to less than 2% in the general population (O’Dwyer et al 2016). IDS-TILDA has a long-standing collaboration with the School of Pharmacy and Pharmaceutical Sciences who are investigating all things pharmacological within the study. Lead by Prof. Martin Henman and Prof. Máire O’Dwyer the pharmacy team continue to scrutinise the data, have supported numerous PhD, masters and undergraduate students and have successfully secured over 300k funding to further investigate in an endeavour to inform practice, promote best practice and optimise medicine use among individuals with intellectual disability.

O'Dwyer, M., Peklar, J., McCallion, P., McCarron, M. and Henman, M.C., 2016. Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: a cross-sectional observational nationwide study. BMJ open, 6(4), p.e010505. https://doi.org/10.1136/bmjopen-2015-010505

The keystone projects are EQUIP (led by Dr Máire O’Dwyer) and OPTIMA-ID (led by Dr Juliette O’Connell).

Theme Lead: Prof Máire O'Dwyer

Affiliated Academic Staff: Prof Juliette O'Connell and Prof Martin Henman

EQUIP - Summary.

EQUIP: Examining Quality, Use and Impact of Psychotropic (Use) in older adults with intellectual disabilities.

Widespread, and sometimes inappropriate use of psychotropics in adults with intellectual disability has been an international concern. These medicines have been used to treat mental health conditions, but also controversially behaviours in the absence of a diagnosis. Results from the IDS-TILDA study of older adults with intellectual disability in Ireland revealed that 60% were taking psychotropics in 2010. In the past ten years changes in regulation, policy and decongregation for people with intellectual disability has taken place. The HSE National Clinical Programme for People with Disability (NCPDD) was established in 2020 and has medicines optimisation as a key priority. Therefore, the main aim of EQUIP is to examine the quality and trends of psychotropic use of older adults with intellectual disability over a ten-year period in Ireland.

EQUIP is using health and medication data from ten years of the IDS-TILDA study (comprising all four waves), as well as medicines data from the HSE-PSCR prescribing database. We are examining the impact of long-term psychotropic use, changes in trends of psychotropic use, and the impact of decongregation on medicines use.

Data generated from this study will inform the development of national guidance on medicines optimisation for older people with intellectual disability. Engagement of adults with intellectual disability and knowledge users in the oversight, task group and dissemination of findings has the potential to optimise medicines use, change prescribing practices and improve health and wellbeing.

Colleagues on the EQUIP study include the Faculty of Learning Disability in the College of Psychiatrists of Ireland, the HSE NCPDD, and patient stakeholders.

EQUIP is funded by the Health Research Board Secondary Data Analysis Projects fund.

OPTIMA-ID Summary

OPTIMA-ID: Optimising Pharmaco-Therapy and Improving Medication for Ageing with Intellectual Disability will develop a pharmacotherapy optimisation tool.

People with intellectual disability have unique medication needs and frequently report high levels of psychotropic use, including antipsychotics which are often used off-licence. They experience high levels of anticholinergic and sedative exposure, while also reporting undertreatment of certain conditions, including pain. Communication challenges and altered ageing processes also affect medication optimisation in this group. An evidence-based framework is needed to structure medicine optimisation for older people with intellectual disabilities. Medication optimisation in older adults improves medication appropriateness and reduces adverse effects and harm. Despite availability of tools to optimise older people’s prescriptions, there is no comprehensive tool specific for use in older adults (i.e. ≥40 years) with intellectual disabilities.

OPTIMA-ID will be developed through an extensive literature review and focus groups with experts in medicines use and people with intellectual disabilities. A final tool will be developed by consensus achieved using Delphi methodology, the contents of this will be informed by the literature review and focus groups.

OPTIMA-ID has received funding from the Dean’s Award and further funding will be sought for its broader roll out. It will be investigated as an intervention to improve prescribing and patient outcomes in future.

PhD Researchers

Lamya Al Shuhaimi

“Enhancing medicine use in older adults with intellectual disabilities”

Tell me a little about your chosen research area and what your PhD involves?

My research area is pharmacoepidemiology, specifically my research is aiming to identify possible long-term adverse effects associated with the use of anticholinergics among older adults with intellectual disabilities. The research will explore prescribers view on prescribing anticholinergics among older adults with intellectual disabilities, I will then develop an intervention to optimise prescribing of medication among this vulnerable group of population.

Why have you an interest in this area?

I became interested in anticholinergic burden while preparing my Master thesis in Robert Gordan University, UK. Little research has been conducted on the long-term adverse effect of anticholinergics especially in people with intellectual disability.

What impact would you like your research to have?

My goal is to optimise prescribing of anticholinergics among older adults with intellectual disabilities.

PhD Publications

Al Shuhaimi L, Henman M, McCallion P, McCarron M, O’Dwyer M. The impact of long-term exposure to anticholinergics among people with intellectual disabilities: a scoping review protocol. HRB Open Research. 2021;4:62. https://doi.org/10.12688/hrbopenres.13266.1

Rosemary Monaghan

“Patterns of medication use associated with epilepsy and comorbid behavioural and mental disorders in older people with intellectual disability”

Completed 2022

Brief bio:

Rosemary is a registered pharmacist and joined IDS TILDA in Autumn 2016. She commenced her PhD in 2017 with IDS TILDA and the School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin under the supervision of Associate Prof Martin Henman and Assistant Prof Maire O’Dwyer. Rosemary’s PhD work focuses on medication use associated with mental health and behavioural problems in older adults with epilepsy and an intellectual disability in Ireland.

Qualifications: B.Sc. (Pharmacy) Trinity College Dublin, M. Pharm Royal College of Surgeons in Ireland (RCSI), PG Cert (Statistics) Trinity College Dublin, M.P.S.I (Member Pharmaceutical Society of Ireland).

Highlights:

The aim of my PhD was to understand the characteristics of participants with intellectual disability reporting a diagnosis of epilepsy and mental health disorders, and the patterns of their medication use with regards to psychotropic drugs.

High levels of antiepileptic medication, co-prescribed psychotropic medication and inter-class psychotropic polypharmacy were found in Wave 3 of IDS-TILDA, with the prevalence of epilepsy found to be 35.8%.

We found that medication that is recommended to be avoided in epilepsy (i.e., potential seizure threshold lowering psychotropic medication) was not associated with an increased seizure frequency in this group.

A high prevalence of challenging behaviour was found in participants with epilepsy who take regular antiepileptic medication (62.7%), with a high antiepileptic drug load found to be associated with some behavioural problems, particularly aggressive/destructive behaviour.

Aggressive/destructive and stereotyped behaviours were found to be significantly more likely in participants living in residential campus settings, with level of intellectual disability found to be significantly associated with exhibiting challenging behaviours.

PhD Publications

Monaghan R, O'Dwyer M, Luus R, Mulryan N, McCallion P, McCarron M, Henman MC. The relationship between antiepileptic drug load and challenging behaviors in older adults with intellectual disability and epilepsy. Epilepsy & Behavior. 2021;122:108191. https://doi.org/10.1016/j.yebeh.2021.108191

Monaghan R, O'Dwyer M, Mulryan, Luus R, McCarron M, McCallion P, Henman M. Antiepileptic drugs, occurrence of seizures and effect of co-administration of potential seizure threshold lowering psychotropic drugs in adults with intellectual disability who have epilepsy. Journal of Applied Research in Intellectual Disabilities. 2021;34:816-29. https://doi.org/10.1111/jar.12857

Previous PhD researchers:

Dr Hadiah Khalaf Almutairi “Factors associated with the use of gastrointestinal medicines among older people with intellectual disabilities in Ireland” Completed 2020

Dr Juliette O’Connell “Addressing the complexity of medication use in older people with intellectual disability” Completed 2019

Dr Máire O’Dwyer “Prevalence, patterns and factors associated with multiple medicines use in an ageing population with intellectual disability in Ireland” Completed 2015

Bio's for Research Staff:

Ashleigh Gorman

Ashleigh is a research assistant working on the development of OPTIMA-ID: Optimising Pharmaco-Therapy and Improving Medication for Ageing with Intellectual Disability (lead by Assistant Professor Juliette O’Connell) as well as EQUIP: Examining Quality, Use and Impact of Psychotropic (Use) in older adults with intellectual disabilities (lead by Assistant Professor Máire O’Dwyer). Prior to joining IDS-TILDA, Ashleigh worked as a project lead on the To-Reach study (a joint European research programme aimed at producing research evidence to support healthcare services) at the Health Research Board, and as a health information officer at the Public Health Agency in Northern Ireland. She is currently completing her PhD on appropriate prescribing for older adults in primary care at Trinity College Dublin.

Ashleigh enjoys bringing research and science to the general population and volunteers as Co-Director of Pint of Science Ireland; a charity which brings science, technology, engineering and arts and humanities researchers to local pubs and cafes to share their work and make science more accessible.

Research interests: ageing, intellectual disability, healthcare, health promotion, access to healthcare, sociology of health

Qualifications: MSc in Applied Social Research, Trinity College Dublin; BSc (Hons) in Sociology and Criminology, Ulster University; Dip International Studies, Rhodes College Tennessee

Tara Mullaly

Tara is the Summer Research Assistant for OPTIMA-ID (Optimising Pharmaco-Therapy and Improving Medication for Ageing with Intellectual Disability).

She is a final year Pharmacy Student at Trinity College Dublin. She has previously worked as a Special Needs Assistant at St. Michael’s Centre for Autism, where she supported and cared for children with intellectual disability.

Tara conducts the literature review which will inform the Delphi study. She is also involved in developing focus groups for people with intellectual disability including creating study material.

Tara is a Field Researcher for Wave 5 of IDS-TILDA.

Publications:

Watkins L, O’Dwyer M, Shankar R. Pharmacotherapeutic considerations for managing epilepsy in autistic people: a review. Expert Opinion on Pharmacotherapy. 2022;23:841-51. Doi: 10.1080/14656566.2022.2055461 Journal article

Winterhalder R, McCabe J, Young C, Lamb K, Sawhney I, Jory C, O’Dwyer M, Shankar R. Bone health, intellectual disability and epilepsy: an observational community-based study. Acta Neurologica Scandinavica. 2022;145:753-61. Doi: 10.1111/ane.13612 Journal article

O'Connell J, Strugaru A-M, Grimes T, Medina Martin C, Santos-Martinez M, O'Dwyer M, Roche C, Ryan C. Developing a research programme for MPharm students: application of research skills to practice education. Health and Social Care Professions 3rd National (virtual) Conference on Practice Education, Online, 17th June 2021, 2021 Poster presentation

O'Dwyer M, Watkins L, Henman M, McCallion P, McCarron M, Shankar R. Optimising medicines use in older adults with intellectual disability who have epilepsy: challenges and perspectives. Therapeutic Advances in Drug Safety. 2021;12:1-5. Doi: 10.1177/20420986211025157 Journal article

Al Shuhaimi L, Henman M, McCallion P, McCarron M, O’Dwyer M. The impact of long-term exposure to anticholinergics among people with intellectual disabilities: a scoping review protocol. HRB Open Research. 2021;4:62. Doi: 10.12688/hrbopenres.13266.1 Journal article

O’Connell J. Defensive pharmacy practice: a gap in our understanding. International Journal of Clinical Pharmacy. 2021;43:1718-21. Doi: 10.1007/s11096-021-01285-4 Journal article

Monaghan R, O'Dwyer M, Luus R, Mulryan N, McCallion P, McCarron M, Henman M. Anti-epileptic drugs, seizures and effect of co-administration of potential seizure threshold lowering psychotropic drugs in adults with epilepsy & intellectual disability. Trinity Health and Education International Research Conference 2021 (THEconf2021): 'Transforming healthcare in a changing world: new ways of thinking and working', Dublin, 2021 Oral presentation

Monaghan R, O'Dwyer M, McCallion P, McCarron M, Henman M. The relationship between anti-epileptic drug load and behaviours that challenge in older adults with intellectual disability and epilepsy. Trinity Health and Education International Research Conference 2021 (THEconf2021): 'Transforming healthcare in a changing world: new ways of thinking and working', Dublin, 9th - 11th March, 2021 Oral presentation

Ryan TJ, Ryder SA, D'Arcy DM, Quigley JM, Ng NN, Ong WQ, Tey ZH, O'Dwyer M, Walsh JJ. Development of professional attributes through integration of science and practice at first-year pharmacy level. Pharmacy, 2021;9:4. Doi: 10.3390/pharmacy9010004 Journal article

Monaghan R, O'Dwyer M, McCallion P, McCarron M, Henman M. Patterns of anti-epileptic drug use, seizures and co-administration of proconvulsive psychotropic drugs in older adults with epilepsy and intellectual disability in Ireland. Trinity Health and Education International Research Conference: Integrated Health Care Developing Integrated Person-Centered Health Systems, TheConfo2020, Dublin, 3rd - 5th March, 2020 Oral presentation

O'Connell J, O'Dwyer M, McCallion P, McCarron M, Henman M. Frailty and its association with medication use in older adults with intellectual disability: an observational cross-sectional study. Trinity Health and Education International Research Conference: Integrated Health Care Developing Integrated Person-Centered Health Systems, TheConfo2020, Dublin, 3rd - 5th March, 2020 Oral presentation

Sheerin F, McCallion P, McGlinchey E, O’Dwyer M, Reilly E, McCarron M. Aging with intellectual disability: dementia and cognitive decline. In Handbook of Dual Diagnosis. Matson E (eds). Switzerland, Springer Nature. 2000 Book chapter

Bond L, Carroll R, Mulryan N, O'Dwyer M, O'Connell J, Monaghan R, Sheerin F, McCallion P, McCarron M. Biopsychosocial factors associated with depression and anxiety in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Journal of intellectual disability research: JIDR. 2020;64:368-380 Journal article

O'Dwyer M, McCallion P, McCarron M, O'Connell J, Henman M. Measuring drug burden in older adults with intellectual disabilities: Critical issues for consideration in finding the optimal measure to improve safety of medicines use. Expert opinion on drug safety. 2020;19:649-52. Doi: 10.1080/14740338.2020.1751119 Journal article

Watkins L, O’Dwyer M, Oak K, Lawthom C, Maguire M, Thomas R, Shankar R. The evidence for switching dibenzazepines in people with epilepsy. Acta Neurologica Scandinavica. 2020;142:121-30. Doi: 10.1111/ane.13248 Journal article

O' Connell J, Burke E, McMahon N, McCallion P, McCarron M, Henman M, O'Dwyer M. Medication burden and frailty in older adults with intellectual disability: an observational cross-sectional study. Pharmacoepidemiology and Drug Safety. 2020;29:482-92. Doi: 10.1002/pds.4987 Journal article

O'Dwyer M, Ryan T, Ryder S, D'Arcy DM, Walsh J. Innovative development and evaluation of professional attributes through integration of science and practice at first year pharmacy level. Irish Network of Healthcare Educators Conference, TBSI, Trinity College Dublin, Dublin, Ireland, February 2020, 2020 Oral Presentation

Watkins L, O'Dwyer M, Kerr M, Scheepers M, Courtenay K, Shankar R. Quality Improvement in the management of people with epilepsy and Intellectual Disability: the development of clinical guidance. Expert Opinion on Pharmacotherapy. 2019;21:173-81. Doi: 10.1080/14656566.2019.1695780 Journal Article

Al Mutairi HK, O'Dwyer M, McCarron M, McCallion P, Burke E, Henman MC. Laxative use among older adults with intellectual disability: A cross-sectional observational study. International Journal of Clinical Pharmacy. 2019;42:88-99. Doi: 10.1007/s11096-018-0759-9. Conference Paper

O’Dwyer M. Polypharmacy in older adults with intellectual disability (webinar). International Foundation for Integrated Care (IFIC) Integrated Matters, Scotland. 2019. Webinar on Appropriate Polypharmacy & Adherence. Invited Talk

Ryan TJ, Grimes T, Henman MC, Sheachnasaigh EN, O'Dwyer M, Roche C, Ryder SA, Sasse A, Walsh JJ, D'Arcy DM. Design and implementation of an integrated competency-focused pharmacy programme: a case report. Pharmacy. 2019;7:121. Doi: 10.3390/pharmacy7030121 Journal Article

O'Connell J, Henman MC, Burke É, Donegan C, McCallion P, McCarron M, O'Dwyer M. Association of Drug Burden Index with grip strength, timed up and go and Barthel index activities of daily living in older adults with intellectual disabilities: an observational cross-sectional study. BMC Geriatrics. 2019;19:173. Doi: 10.1186/s12877-019-1190-3 Journal Article

O'Dwyer M, Finnerty S, Henman M, Carroll R, McCallion P, McCarron M. Prevalence and treatment of dementia in older adults with Intellectual Disability (ID) in Ireland. Journal of Intellectual Disability Research. IASSIDD World Congress, Glasgow, 2019. Doi: 10.1111/jir.12651 Conference Paper

Al Mutairi HK, O'Dwyer M, McCarron M, McCallion P, Henman MC. Longitudinal evaluation of laxative use among people with intellectual disabilities: data from three waves of a longitudinal study. International Journal of Clinical Pharmacy. European Society of Clinical Pharmacy Symposium, Belfast, 2019. Doi: 10.1007/s11096-018-0759-9 Conference Paper

O'Connell J, Burke E, O'Dwyer M, McCallion P, McCarron M, Henman MC. Drug burden measures and physical function in older adults with intellectual disabilities. International Journal of Clinical Pharmacy, European Society of Clinical Pharmacy Symposium, Belfast, 2019. Doi: 10.1007/s11096-018-0759-9 Conference Paper

Burke É, Carroll R, O'Dwyer M, Walsh JB, McCallion P, McCarron M. Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: a cross-sectional nationwide study. BMJ Open. 2019;9:e026939. Doi: 10.1136/ bmjopen-2018-026939 Journal Article

Watkins L, O’Dwyer M, Shankar R. New anti-seizure medication for elderly epileptic patients. Expert Opinion on Pharmacotherapy. 2019;20:1601-8. Doi: 10.1080/1465566.2019.1618272. Journal Article

O'Dwyer C, Henman M, Mc Carron M, O'Leary E, McCallion P, Burke É, O'Connell J, O'Dwyer M. Prevalence and patterns of antipsychotic use and their associations with mental health and problem behaviours among older adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities. 2019;32:981-993. Doi: 10.1111/jar.12591 Journal Article

Burke É, O’Dwyer M, McGlinchey E, Foran S, MacGiolla Phadraig C, Carroll R, McCallion P, McCarron M. 2019. Important physical health issues, in Prasher VP & Janicki MP (eds) Physical health of adults with intellectual disabilities. London: Wiley, pp:27-52. Book Chapter

Ryan C, O’Dwyer M. 2019. Pharmaceutical care in the aged, in da Costa Fam Alvarez Risco A, van Mil f (eds) The Pharmacist Guide to Implementing Pharmaceutical Care. Springer International. Book Chapter

Burke É, O’Dwyer M, McGlinchey E, Foran S, MacGiolla Phadraig C, Carroll R, McCallion P, McCarron M. 2019. Physical health of older adults with intellectual disability, in Prasher VP & Janicki M (eds) Physical Health of People with Intellectual Disability. Springer International. Book Chapter

O'Dwyer M, Peklar J, Mulryan N, McCallion P, McCarron M, Henman MC. Prevalence and patterns of anti-epileptic medication prescribing in the treatment of epilepsy in older adults with intellectual disabilities. Journal of Intellectual Disability Research. 2018;62:245-61. Doi: 10.1111/jir.12461 Journal Article

O'Dwyer M, Galvin N, McCallion P, McCarron M, Henman M, O'Connell J. Patterns of antipsychotic utilization and associations with behaviours, with challenges in older adults with intellectual disability: a cross sectional study. Journal of Applied Research in Intellectual Disability.2018;31:544. Fifth International IASSIDD Europe Congress, Athens, Greece. Oral Presentation

Burke E, Carroll, R, O'Dwyer M, Walsh J, McCallion P, McCarron M. Sing chi-square automatic interaction detection modelling to identify predictors of osteoporosis among adults with Intellectual Disability. Journal of Applied Research in Intellectual Disability. 2018;31:554. Fifth International IASSIDD Europe Congress, Athens, Greece. Oral Presentation

O'Connell J, Burke E, Henman M, McCallion P, McCarron M, O'Dwyer M. A comparison of drug burden measures on physical function scores in a cohort of older adults with Intellectual Disabilities. Journal of Applied Research in Intellectual Disability. 2018;31:553. Fifth International IASSIDD Europe Congress, Athens, Greece. Poster Presentation

O'Dwyer C, McCallion P, Burke E, Carroll R, O'Dwyer M, McCarron M. Prevalence and associated factors of problem behaviours among older adults with intellectual disabilities in Ireland. Research in Developmental Disabilities. 2018;80:192-204. Doi: 10.1016/j.ridd.2018.05.007. Journal Article

Burke EA, O’Dwyer M, McGlinchey E, Foran S, MacGiolla Phadraig C, Carroll R, McCallion P, McCarron M. 2018. Overview of the important physical health concerns, in Prasher VP and Janicki MP (eds) Physical Health of Adults with Intellectual Disabilities. Springer Nature. Book Chapter

Burke EA, Carroll R, O'Dwyer M, Walsh JB, McCallion P, McCarron M. Osteoporosis and people with Down Syndrome: a preliminary descriptive examination of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing Wave 1 Results. Health. 2018;10:1233-49. Doi: 10.4236/health.2018.109095 Journal Article

O'Dwyer M, Burke E, Foran S, McCarron M, McCallion P. Associations of medicine use with falls and bone health in older adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities. 2018;31:544. IASSIDD European Congress, Athens. Doi: 10.1111/jar.12485 Conference Paper

O'Dwyer M, Hughes J, McCallion P, McCarron M, Henman M. Psychotropic drug use in older adults with intellectual disabilities who have dementia in Ireland. Journal of Applied Research in Intellectual Disabilities. 2018;31:544. IASSIDD European Congress, Athens. Doi: 10.1111/jar.12485 Conference Paper

O'Dwyer M, Galvin N, McCallion P, McCarron M, Henman M, O'Connell J. Use of high risk medicines in older adults with Intellectual Disabilities: a cross-sectional study. Journal of Applied Research in Intellectual Disabilities. 22018;31:544. IASSIDD European Congress, Athens , 31, (4), 2018, pp544 – 544. Doi: 10.1111/jar.12485 Conference Paper

Almutari H, O'Dwyer M, McCarron M, McCallion P, Henman M. The use of proton pump inhibitors among older sdults with Intellectual Disability: a cross sectional observational study. Saudi Pharmaceutical Journal. 2018;262:1012-21. Doi: 10.1016/j.jsps.2018.02.009 Journal Article

Belton A, O'Dwyer M, Peklar J, McCallion P, McCarron M, Henman M. Medication use and health screening in an ageing adult population with Down Syndrome in Ireland: a descriptive study. Journal of Policy and Practice in Intellectual Disabilities. 2018;15:145-54. Doi: 10.1111/jppi.12241 Journal Article

O Connell J, Burke E, Donegan C, McCallion P, McCarron M, Henman M, O'Dwyer M. Effect of Drug Burden Index on physical function measures in older adults with Intellectual Disabilities: an observational cross-sectional study. BMC. 2018;84:553-67. Doi: 10.1111/bcp.13479. Journal Article

Almutari H, O'Dwyer M, Burke E, McCarron M, McCallion P, Henman M. Laxatives use and constipation among Intellectually Disabled older people, prevalence, patterns and association: a cross-sectional observational study. Drugs and Aging. 2018 Journal Article

O'Dwyer M, McCarron M, McCallion P, Henman M. Medication use and potentially inappropriate prescribing in older adults with Intellectual Disabilities: a neglected area of research. Therapeutic Advances in Drug Safety. 2018;9:535-57. Doi: 10.1177/2042098618782785 Journal Article

O'Dwyer M, O'Connell J, O'Dwyer C, Mulryan N, McCallion P, McCarron M, Henman MC. Patterns and indications for antipsychotic utilisation in older adults with intellectual disability: a cross sectional study. International Journal of Pharmacy Practice. 2018:26:7. Health Services Research and Pharmacy Practice Conference, Newcastle. Oral Presentation

Coughlan M, McCarthy S, Melanophy G, O'Dwyer M. An analysis of the medication reconciliation process in an outpatient clinical setting. Hospital Pharmacists Association of Ireland Annual Conference, Dublin, 2018. Poster Presentation

O'Connell J, Burke E, Mulryan N, O'Dwyer C, Donegan C, McCallion P, McCarron M, Henman M, O'Dwyer M. Drug Burden Index to define the burden of medicines in older adults with Intellectual Disabilities: an observational cross-sectional study. British Journal of Clinical Pharmacology. 2018;84:553-67. Doi: 10.1111/bcp.13479 Journal Article

O'Dwyer M, Henman M, McCarron M, McCallion P, Burke E, Carroll R, O'Dwyer M, O'Connell J. Prevalence and patterns of antiepileptic medication use in the treatment of epilepsy in older adults with Intellectual Disabilities. Journal of Intellectual Disability Research. 2018;62:245-61. Doi: 10.1111/jir.12461 Journal Article

Almutairi H, O'Dwyer M, McCarron M, McCallion P, Henman M. The use of Proton Pump Inhibitors among older adults with Intellectual Disability: cross sectional observational study. Saudi Pharmaceutical Journal. 2018. Doi: 10.1093/ageing/afw159.163 Journal Article

Belton A, O'Dwyer M, Peklar J, Mccallion P, McCarron M, Henman M. Medication use and health screening in an ageing adult population with Down Syndrome in Ireland: A descriptive study. Journal of Policy and Practice in Intellectual Disabilities. 2018;15:145-54. Doi: 10.1111/jppi.12241 Journal Article