ArticleHRB open research2026
A protocol for application of OPTIMA-ID to identify potentially inappropriate prescribing in a cohort of older adults with intellectual disability.
Article in HRB open research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Adults with intellectual disability age differently, with differing comorbid conditions, prescribing patterns, and medication management considerations than the general population. The Optimising Pharmaco-Therapy and Improving Medication for Ageing with Intellectual Disability (OPTIMA-ID) tool is a newly described set of prescribing criteria developed by expert consensus designed specifically for medicines optimisation in older adults with intellectual disability. The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) is key source of observational evidence for medicines in this population. OPTIMA-ID must be tested in the population of older adults with intellectual disability to investigate applicability of the tool for medicines optimisation in clinical practice and to describe potentially inappropriate prescribing for the first time in Ireland. Methods: To design a method for the application of OPTIMA-ID to IDS-TILDA data for the first time, the OPTIMA-ID tool was operationalised by translating the criteria into codable statements. These were used to develop bespoke functions in the programming language R for application to the health, behavioural and medicines data from the fifth Wave of IDS-TILDA data collection. Results: For the Wave 5 IDS-TILDA dataset, 52 of 67 (78%) OPTIMA-ID criteria were applicable. They were translated into codable statements and built into functions in R for computerised application to the dataset. These functions produce an output of either True or False depending on whether the conditions for each OPTIMA-ID criteria are met, and identify the responsible medicine's Anatomical Therapeutic Chemical code where relevant. Conclusion: This protocol describes a method for the application of a novel medicines optimisation tool in a population of older adults with intellectual disability in Ireland, using accurate, computational methods to identify and describe potentially inappropriate prescribing in this population. This will be first study to use OPTIMA-ID to demonstrate its applicability in its intended target population.
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