Skip to main content
Erschienen in: International Journal of Clinical Pharmacy 1/2020

02.12.2019 | Research Article

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

verfasst von: Hadiah AlMutairi, Máire O’Dwyer, Elish Burke, Mary McCarron, Philip McCallion, Martin C. Henman

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Peklar J, Kos M, O’Dwyer M, McCarron M, McCallion P, Kenny RA, et al. Medication and supplement use in older people with and without intellectual disability: an observational, cross-sectional study. PLoS ONE. 2017;12(9):e0184390.PubMedPubMedCentral Peklar J, Kos M, O’Dwyer M, McCarron M, McCallion P, Kenny RA, et al. Medication and supplement use in older people with and without intellectual disability: an observational, cross-sectional study. PLoS ONE. 2017;12(9):e0184390.PubMedPubMedCentral
3.
Zurück zum Zitat Velde SV, VanBiervliet S, Van Goethem G, De Looze D, Van Winckel M. Colonic transit time in mentally retarded persons. Int J Colorectal Dis. 2010;25:867–71. Velde SV, VanBiervliet S, Van Goethem G, De Looze D, Van Winckel M. Colonic transit time in mentally retarded persons. Int J Colorectal Dis. 2010;25:867–71.
4.
Zurück zum Zitat Johanson JF, Sonnenberg A, Koch TR, McCarty DJ. Association of constipation with neurologic diseases. Dig Dis Sci. 1992;37:179–86.PubMed Johanson JF, Sonnenberg A, Koch TR, McCarty DJ. Association of constipation with neurologic diseases. Dig Dis Sci. 1992;37:179–86.PubMed
5.
Zurück zum Zitat Morad M, Nelson NP, Merrick J, Davidson PW, Carmeli E. Prevalence and risk factors of constipation in adults with intellectual disability in residential care centers in Israel. Res Dev Disabil. 2007;28:580–6.PubMed Morad M, Nelson NP, Merrick J, Davidson PW, Carmeli E. Prevalence and risk factors of constipation in adults with intellectual disability in residential care centers in Israel. Res Dev Disabil. 2007;28:580–6.PubMed
6.
Zurück zum Zitat Böhmer CJM, Taminiau J, Klinkenberg-Knol EC, Meuwissen SGM. The prevalence of constipation in institutionalized people with intellectual disability. J Intellect Disabil Res. 2001;45:212–8.PubMed Böhmer CJM, Taminiau J, Klinkenberg-Knol EC, Meuwissen SGM. The prevalence of constipation in institutionalized people with intellectual disability. J Intellect Disabil Res. 2001;45:212–8.PubMed
7.
Zurück zum Zitat Humphries K, Traci MA, Seekins T. Nutrition and adults with intellectual or developmental disabilities: systematic literature review results. Intellect Dev Disabil. 2009;47:163–85.PubMed Humphries K, Traci MA, Seekins T. Nutrition and adults with intellectual or developmental disabilities: systematic literature review results. Intellect Dev Disabil. 2009;47:163–85.PubMed
8.
Zurück zum Zitat O’Dwyer M, Maidment ID, Bennett K, Peklar J, Mulryan N, McCallion P, et al. Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an observational cross-sectional study. Br J Psychiatry. 2016;209:504–10.PubMed O’Dwyer M, Maidment ID, Bennett K, Peklar J, Mulryan N, McCallion P, et al. Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an observational cross-sectional study. Br J Psychiatry. 2016;209:504–10.PubMed
9.
Zurück zum Zitat Alexander RT, Shankar R, Cooper SA, Bhaumik S, Hastings R, Kapugama CL, et al. Challenges and pitfalls of antipsychotic prescribing in people with learning disability. Br J Gen Pract. 2017;67:372–3.PubMedPubMedCentral Alexander RT, Shankar R, Cooper SA, Bhaumik S, Hastings R, Kapugama CL, et al. Challenges and pitfalls of antipsychotic prescribing in people with learning disability. Br J Gen Pract. 2017;67:372–3.PubMedPubMedCentral
10.
Zurück zum Zitat Marciniak CM, Lee J, Jesselson M, Gaebler-Spira D. Cross-sectional study of bowel symptoms in adults with cerebral palsy: prevalence and impact on quality of life. Arch Phys Med Rehabil. 2015;96:2176–83.PubMed Marciniak CM, Lee J, Jesselson M, Gaebler-Spira D. Cross-sectional study of bowel symptoms in adults with cerebral palsy: prevalence and impact on quality of life. Arch Phys Med Rehabil. 2015;96:2176–83.PubMed
11.
Zurück zum Zitat Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Ther. 2010;31:938–49.PubMed Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Ther. 2010;31:938–49.PubMed
13.
Zurück zum Zitat Evenhuis HM. Medical aspects of ageing in a population with intellectual disability: III. Mobility, internal conditions and cancer. J Intellect Disabil Res. 1997;41:8–18.PubMed Evenhuis HM. Medical aspects of ageing in a population with intellectual disability: III. Mobility, internal conditions and cancer. J Intellect Disabil Res. 1997;41:8–18.PubMed
14.
Zurück zum Zitat Robertson J, Baines S, Emerson E, Hatton C. Prevalence of constipation in people with intellectual disability: a systematic review. J Intellect Dev Disabil. 2018;43:392–406. Robertson J, Baines S, Emerson E, Hatton C. Prevalence of constipation in people with intellectual disability: a systematic review. J Intellect Dev Disabil. 2018;43:392–406.
15.
Zurück zum Zitat Straetmans JM, van Schrojenstein Lantman-de HM, Schellevis FG, Dinant G-J. Health problems of people with intellectual disabilities: the impact for general practice. Br J Gen Pract. 2007;57:64–6.PubMedPubMedCentral Straetmans JM, van Schrojenstein Lantman-de HM, Schellevis FG, Dinant G-J. Health problems of people with intellectual disabilities: the impact for general practice. Br J Gen Pract. 2007;57:64–6.PubMedPubMedCentral
16.
Zurück zum Zitat Vetrano DL, Tosato M, Colloca G, Topinkova E, Fialova D, Gindin J, et al. Polypharmacy in nursing home residents with severe cognitive impairment: results from the SHELTER Study. Alzheimers Dement. 2013;9:587–93.PubMed Vetrano DL, Tosato M, Colloca G, Topinkova E, Fialova D, Gindin J, et al. Polypharmacy in nursing home residents with severe cognitive impairment: results from the SHELTER Study. Alzheimers Dement. 2013;9:587–93.PubMed
17.
Zurück zum Zitat O’Dwyer M, Peklar J, McCallion P, McCarron M, Henman MC. 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. 2016;6(4):e010505.PubMedPubMedCentral O’Dwyer M, Peklar J, McCallion P, McCarron M, Henman MC. 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. 2016;6(4):e010505.PubMedPubMedCentral
18.
Zurück zum Zitat Robertson J, Baines S, Emerson E, Hatton C. Constipation management in people with intellectual disability: a systematic review. J Appl Res Intellect Disabil. 2018;31:709–24.PubMed Robertson J, Baines S, Emerson E, Hatton C. Constipation management in people with intellectual disability: a systematic review. J Appl Res Intellect Disabil. 2018;31:709–24.PubMed
19.
Zurück zum Zitat Daniels G. Giving laxatives safely and effectively. Medsurg Nurs. 2013;22(290–6):302. Daniels G. Giving laxatives safely and effectively. Medsurg Nurs. 2013;22(290–6):302.
20.
Zurück zum Zitat McCarron M, Swinburne J, Burke E, McGlinchey E, Mulryan N, Andrews V, et al. Growing older with an intellectual disability in Ireland 2011: first results from the intellectual disability supplement of the Irish longitudinal study on ageing: an accessible report. Dublin: School of Nursing & Midwifery, Trinity College Dublin; 2011. McCarron M, Swinburne J, Burke E, McGlinchey E, Mulryan N, Andrews V, et al. Growing older with an intellectual disability in Ireland 2011: first results from the intellectual disability supplement of the Irish longitudinal study on ageing: an accessible report. Dublin: School of Nursing & Midwifery, Trinity College Dublin; 2011.
21.
Zurück zum Zitat McCarron M, McCallion P, Carroll R, Burke E, Cleary E, McCausland D, et al. Advancing years, different challenges: wave 2 IDS-TILDA: findings on the ageing of people with an intellectual disability: an intellectual disability supplement to the Irish longitudinal study on ageing. Dublin: Trinity College Dublin; 2014. McCarron M, McCallion P, Carroll R, Burke E, Cleary E, McCausland D, et al. Advancing years, different challenges: wave 2 IDS-TILDA: findings on the ageing of people with an intellectual disability: an intellectual disability supplement to the Irish longitudinal study on ageing. Dublin: Trinity College Dublin; 2014.
22.
Zurück zum Zitat Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12:1500–24.PubMed Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12:1500–24.PubMed
23.
Zurück zum Zitat McCarron M, Swinburne J, Burke E, McGlinchey E, Carroll R, McCallion P. Patterns of multimorbidity in an older population of persons with an intellectual disability: results from the intellectual disability supplement to the Irish longitudinal study on aging (IDS-TILDA). Res Dev Disabil. 2013;34:521–7.PubMed McCarron M, Swinburne J, Burke E, McGlinchey E, Carroll R, McCallion P. Patterns of multimorbidity in an older population of persons with an intellectual disability: results from the intellectual disability supplement to the Irish longitudinal study on aging (IDS-TILDA). Res Dev Disabil. 2013;34:521–7.PubMed
24.
Zurück zum Zitat McCarron M, Carroll R, Kelly C, McCallion P. Mortality rates in the general Irish population compared to those with an intellectual disability from 2003 to 2012. J Appl Res Intellect Disabil. 2015;28:406–13.PubMed McCarron M, Carroll R, Kelly C, McCallion P. Mortality rates in the general Irish population compared to those with an intellectual disability from 2003 to 2012. J Appl Res Intellect Disabil. 2015;28:406–13.PubMed
25.
Zurück zum Zitat Tse MM, Kwan RY, Lau JL. Ageing in individuals with intellectual disability: issues and concerns in Hong Kong. Hong Kong Med J. 2018;24:68–72.PubMed Tse MM, Kwan RY, Lau JL. Ageing in individuals with intellectual disability: issues and concerns in Hong Kong. Hong Kong Med J. 2018;24:68–72.PubMed
26.
Zurück zum Zitat Evenhuis HM, Hermans H, Hilgenkamp TIM, Bastiaanse LP, Echteld MA. Frailty and disability in older adults with intellectual disabilities: results from the healthy ageing and intellectual disability study. J Am Geriatr Soc. 2012;60:934–8.PubMed Evenhuis HM, Hermans H, Hilgenkamp TIM, Bastiaanse LP, Echteld MA. Frailty and disability in older adults with intellectual disabilities: results from the healthy ageing and intellectual disability study. J Am Geriatr Soc. 2012;60:934–8.PubMed
27.
Zurück zum Zitat Krinsky-McHale SJ, Silverman W. Dementia and mild cognitive impairment in adults with intellectual disability: issues of diagnosis. Dev Disabil Res Rev. 2013;18:31–42.PubMed Krinsky-McHale SJ, Silverman W. Dementia and mild cognitive impairment in adults with intellectual disability: issues of diagnosis. Dev Disabil Res Rev. 2013;18:31–42.PubMed
29.
Zurück zum Zitat Joint Formulary Committee. British National Formulary (BNF). 68th ed. London: BMJ Group and Pharmaceutical Press; 2015. Joint Formulary Committee. British National Formulary (BNF). 68th ed. London: BMJ Group and Pharmaceutical Press; 2015.
30.
Zurück zum Zitat Shih DQ, Kwan LY. All roads lead to Rome: update on Rome III criteria and new treatment options. Gastroenterol Rep. 2007;1:56–65.PubMedPubMedCentral Shih DQ, Kwan LY. All roads lead to Rome: update on Rome III criteria and new treatment options. Gastroenterol Rep. 2007;1:56–65.PubMedPubMedCentral
31.
Zurück zum Zitat Richardson K, Moore PV, Peklar J, Galvin R, Bennett K, Kenny RA. Polypharmacy in adults over 50 in Ireland: opportunities for cost savings and improved healthcare. Dublin: The Irish Longitudinal Study on Ageing TILDA, Trinity College Dublin; 2012. Richardson K, Moore PV, Peklar J, Galvin R, Bennett K, Kenny RA. Polypharmacy in adults over 50 in Ireland: opportunities for cost savings and improved healthcare. Dublin: The Irish Longitudinal Study on Ageing TILDA, Trinity College Dublin; 2012.
32.
Zurück zum Zitat O’Connell J, Burke E, Mulryan N, O’Dwyer C, Donegan C, McCallion P, et al. Drug burden index to define the burden of medicines in older adults with intellectual disabilities: an observational cross-sectional study. Br J Clin Pharmacol. 2018;84:553–67.PubMedPubMedCentral O’Connell J, Burke E, Mulryan N, O’Dwyer C, Donegan C, McCallion P, et al. Drug burden index to define the burden of medicines in older adults with intellectual disabilities: an observational cross-sectional study. Br J Clin Pharmacol. 2018;84:553–67.PubMedPubMedCentral
33.
Zurück zum Zitat Sainsbury A, Seebass G, Bansal A, Young JB. Reliability of the Barthel Index when used with older people. Age Ageing. 2005;34:228–32.PubMed Sainsbury A, Seebass G, Bansal A, Young JB. Reliability of the Barthel Index when used with older people. Age Ageing. 2005;34:228–32.PubMed
34.
Zurück zum Zitat Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.PubMed Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.PubMed
36.
Zurück zum Zitat Ojo O. Optimising nutrition for older people with constipation. Nurs Resid Care. 2017;19:440–4. Ojo O. Optimising nutrition for older people with constipation. Nurs Resid Care. 2017;19:440–4.
37.
Zurück zum Zitat Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373–9.PubMed Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373–9.PubMed
38.
Zurück zum Zitat van der Heide DC, van der Putten AAJ, van den Berg PB, Taxis K, Vlaskamp C. The documentation of health problems in relation to prescribed medication in people with profound intellectual and multiple disabilities. J Intellect Disabil Res. 2009;53:161–8.PubMed van der Heide DC, van der Putten AAJ, van den Berg PB, Taxis K, Vlaskamp C. The documentation of health problems in relation to prescribed medication in people with profound intellectual and multiple disabilities. J Intellect Disabil Res. 2009;53:161–8.PubMed
39.
Zurück zum Zitat Van Winckel M, Vander Stichele R, De Bacquer D, Bogaert M. Use of laxatives in institutions for the mentally retarded. Eur J Clin Pharmacol. 1999;54:965–9.PubMed Van Winckel M, Vander Stichele R, De Bacquer D, Bogaert M. Use of laxatives in institutions for the mentally retarded. Eur J Clin Pharmacol. 1999;54:965–9.PubMed
40.
Zurück zum Zitat Blekken LE, Nakrem S, Vinsnes AG, Norton C, Mørkved S, Salvesen Ø, et al. Constipation and laxative use among nursing home patients: prevalence and associations derived from the residents assessment instrument for long-term care facilities (interRAI LTCF). Gastroenterol Res Pract. 2016;2016:1215746.PubMedPubMedCentral Blekken LE, Nakrem S, Vinsnes AG, Norton C, Mørkved S, Salvesen Ø, et al. Constipation and laxative use among nursing home patients: prevalence and associations derived from the residents assessment instrument for long-term care facilities (interRAI LTCF). Gastroenterol Res Pract. 2016;2016:1215746.PubMedPubMedCentral
41.
Zurück zum Zitat Fosnes GS, Lydersen S, Farup PG. Effectiveness of laxatives in elderly—a cross sectional study in nursing homes. BMC Geriatrics. 2011;11:76.PubMedPubMedCentral Fosnes GS, Lydersen S, Farup PG. Effectiveness of laxatives in elderly—a cross sectional study in nursing homes. BMC Geriatrics. 2011;11:76.PubMedPubMedCentral
42.
Zurück zum Zitat Harari D, Gurwitz JH, Avorn J, Choodnovskiy I, Minaker KL. Correlates of regular laxative use by frail elderly persons. Am J Med. 1995;99:513–8.PubMed Harari D, Gurwitz JH, Avorn J, Choodnovskiy I, Minaker KL. Correlates of regular laxative use by frail elderly persons. Am J Med. 1995;99:513–8.PubMed
44.
Zurück zum Zitat Belsey JD, Geraint M, Dixon TA. Systematic review and meta analysis: polyethylene glycol in adults with non-organic constipation. Int J Clin Pract. 2010;64:944–55.PubMed Belsey JD, Geraint M, Dixon TA. Systematic review and meta analysis: polyethylene glycol in adults with non-organic constipation. Int J Clin Pract. 2010;64:944–55.PubMed
45.
Zurück zum Zitat Ashraf W, Pfeiffer RF, Park F, Lof J, Quigley EM. Constipation in Parkinson’s disease: objective assessment and response to psyllium. Mov Disord. 1997;12:946–51.PubMed Ashraf W, Pfeiffer RF, Park F, Lof J, Quigley EM. Constipation in Parkinson’s disease: objective assessment and response to psyllium. Mov Disord. 1997;12:946–51.PubMed
46.
Zurück zum Zitat Voderholzer WA, Schatke W, Muhldorfer BE, Klauser AG, Birkner B, Muller-Lissner SA. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol. 1997;92:95–8.PubMed Voderholzer WA, Schatke W, Muhldorfer BE, Klauser AG, Birkner B, Muller-Lissner SA. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol. 1997;92:95–8.PubMed
47.
Zurück zum Zitat American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society (AGS) updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227–46. American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society (AGS) updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227–46.
48.
Zurück zum Zitat Rao SS, Go JT. Update on the management of constipation in the elderly: new treatment options. Clin Interv Aging. 2010;5:163–71.PubMedPubMedCentral Rao SS, Go JT. Update on the management of constipation in the elderly: new treatment options. Clin Interv Aging. 2010;5:163–71.PubMedPubMedCentral
50.
Zurück zum Zitat Coleman J, Spurling G. Constipation in people with learning disability. BMJ. 2010;340:c222.PubMed Coleman J, Spurling G. Constipation in people with learning disability. BMJ. 2010;340:c222.PubMed
51.
Zurück zum Zitat Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011;60:209–18.PubMed Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011;60:209–18.PubMed
52.
Zurück zum Zitat Mac Giolla Phadraig C, Nunn J, Carroll R, McCarron M, McCallion P. Why do edentulous adults with intellectual disabilities not wear dentures? Wave 2 of the IDS TILDA cohort study. J Prosthodont Res. 2017;61:61–6.PubMed Mac Giolla Phadraig C, Nunn J, Carroll R, McCarron M, McCallion P. Why do edentulous adults with intellectual disabilities not wear dentures? Wave 2 of the IDS TILDA cohort study. J Prosthodont Res. 2017;61:61–6.PubMed
54.
Zurück zum Zitat Robertson J, Chadwick D, Baines S, Emerson E, Hatton C. People with intellectual disabilities and dysphagia. Disabil Rehabil. 2018;40:1345–60.PubMed Robertson J, Chadwick D, Baines S, Emerson E, Hatton C. People with intellectual disabilities and dysphagia. Disabil Rehabil. 2018;40:1345–60.PubMed
55.
Zurück zum Zitat Cichero JA. Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutr J. 2013;12:54.PubMedPubMedCentral Cichero JA. Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutr J. 2013;12:54.PubMedPubMedCentral
56.
Zurück zum Zitat Scheifes A, Egberts TC, Stolker JJ, Nijman HL, Heerdink ER. Structured medication review to improve pharmacotherapy in people with intellectual disability and behavioural problems. J Appl Res Intellect Disabil. 2016;29:346–55.PubMed Scheifes A, Egberts TC, Stolker JJ, Nijman HL, Heerdink ER. Structured medication review to improve pharmacotherapy in people with intellectual disability and behavioural problems. J Appl Res Intellect Disabil. 2016;29:346–55.PubMed
57.
Zurück zum Zitat Rosenman R, Tennekoon V, Hill LG. Measuring bias in self-reported data. Int J Behav Healthc Res. 2011;2:320–32.PubMedPubMedCentral Rosenman R, Tennekoon V, Hill LG. Measuring bias in self-reported data. Int J Behav Healthc Res. 2011;2:320–32.PubMedPubMedCentral
Metadaten
Titel
Laxative use among older adults with intellectual disability: a cross-sectional observational study
verfasst von
Hadiah AlMutairi
Máire O’Dwyer
Elish Burke
Mary McCarron
Philip McCallion
Martin C. Henman
Publikationsdatum
02.12.2019
Verlag
Springer International Publishing
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 1/2020
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-019-00942-z

Weitere Artikel der Ausgabe 1/2020

International Journal of Clinical Pharmacy 1/2020 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.