Challenges of using and managing medication: a meta-ethnography of the experiences and perceptions of people with intellectual disability and people who support them.

objectiveTo explore the challenges experienced by people with intellectual disability, their carers and health and social care professionals when using and managing medication.

designA synthesis of qualitative research using meta-ethnography. DATA SOURCE: We searched seven databases: MEDLINE, Embase, CINAHL, Science, Social Science and Conference Proceedings Citation Indices (Web of Science), Cochrane Library, PsycINFO and Proquest Dissertations and Theses from inception to September 2022 (updated in July 2023). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included studies exploring the challenges and perceptions of people with intellectual disability, their carers and health and social care professionals regarding medication management and use.

resultsWe reviewed 7593 abstracts and 475 full texts, resulting in 45 included papers. Four major themes were identified: (1) Medication-related issues, (2) navigating autonomy and relationships, (3) knowledge and training needs and (4) inequalities in the healthcare system. We formulated a conceptual framework centred around people with intellectual disability and described the interconnectedness between them, their carers and health and social care professionals in the process of managing and using medication. We identified challenges that could be associated with the person, the medication and/or the context, along with a lack of understanding of these challenges and a lack of capability or resources to tackle them. We developed an overarching concept of 'collective collaboration' as a potential solution to prevent or mitigate problems related to medication use in people with intellectual disability.

conclusionsThe effective management of medication for people with intellectual disability requires a collaborative and holistic approach. By fostering person-centred care and shared decision-making, providing educational and practical support, and nurturing strong relationships between all partners involved to form a collective collaboration surrounding people with intellectual disability, improved medication adherence and optimised therapeutic outcomes can be achieved. PROSPERO REGISTRATION NUMBER: CRD42022362903.