Long-term condition management in adults with intellectual disability in primary care: a systematic review

Hanlon, P. , Macdonald, S. , Wood, K., Allan, L. and Cooper, S.-A. (2018) Long-term condition management in adults with intellectual disability in primary care: a systematic review. BJGP Open, 2(1), (doi:10.3399/bjgpopen18X101445)

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Abstract

Background: Adults with intellectual disabilities have higher morbidity and earlier mortality than the general population. Access to primary health care is lower, despite a higher prevalence of many long-term conditions. Aim: To synthesise the evidence for the management of long-term conditions in adults with intellectual disabilities and identify barriers and facilitators to management in primary care. Design & setting: Mixed-methods systematic review. Method: Seven electronic databases were searched to identify both quantitative and qualitative studies concerning identification and management of long-term conditions in adults with intellectual disability in primary care. Both the screening of titles, abstracts, and full texts, and the quality assessment were carried out in duplicate. Findings were combined in a narrative synthesis. Results: Fifty-two studies were identified. Adults with intellectual disabilities are less likely than the general population to receive screening and health promotion interventions. Annual health checks may improve screening, identification of health needs, and management of long-term conditions. Health checks have been implemented in various primary care contexts, but the long-term impact on outcomes has not been investigated. Qualitative findings highlighted barriers and facilitators to primary care access, communication, and disease management. Accounts of experiences of adults with intellectual disabilities reveal a dilemma between promoting self-care and ensuring access to services, while avoiding paternalistic care. Conclusion: Adults with intellectual disabilities face numerous barriers to managing long-term conditions. Reasonable adjustments, based on the experience of adults with intellectual disability, in addition to intervention such as health checks, may improve access and management, but longer-term evaluation of their effectiveness is required.

Item Type:Articles
Additional Information:This project was funded through NHS Greater Glasgow and Clyde.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wood, Miss Karen and Allan, Mrs Linda and Hanlon, Dr Peter and Cooper, Professor Sally-Ann and Macdonald, Dr Sara
Authors: Hanlon, P., Macdonald, S., Wood, K., Allan, L., and Cooper, S.-A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:BJGP Open
Publisher:Royal College of General Practitioners
ISSN:2398-3795
ISSN (Online):2398-3795
Published Online:21 March 2018
Copyright Holders:Copyright © 2018 BJGP Open
First Published:First published in BJGP Open 2(1):bjgpopen18X101445
Publisher Policy:Reproduced under a Creative Commons License

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