Perform a comprehensive health assessment
Perform a periodic comprehensive health assessment using guidelines for primary care of people with intellectual and developmental disabilities (IDD) and adapted tools (eg, the Preventive Care Checklist).10, 11 Include a physical health examination, mental health assessment, and review of the adequacy of financial and other community supports.14, 51
Strongly Recommended
Empirical Expert
Health assessments that attend to specific health issues of people with IDD increase preventive care actions and disease detection.52, 53
Proactively invite patients and train staff
Monitor and seek ways of improving rates and outcomes of comprehensive health assessments of patients with IDD in your practice (eg, by proactively inviting patients, training staff, and aligning such assessments with guidelines for primary care of people with IDD).10, 11, 55, 56
Recommended
Empirical Expert
Success in implementing health assessments depends on making changes to the context and organization of primary care practices.54, 55
Develop a health action plan
Based on health assessments, develop a health action plan that identifies health and related issues in an order of priority and with timelines acceptable to patients and their caregivers. Give a copy to the patient and caregiver.51
Recommended
Expert
A health action plan helps to set goals, clarify responsibilities for health care, and facilitate partnerships among patients, their caregivers, and members of their interprofessional health care team.29
Preventive Care Checklist and Cumulative Patent Profile
Use the Preventive Care Checklist and Cumulative Patient Profile tools, developed by the Developmental Disabilities Primary Care Initiative at Surrey Place (Toronto, 2011) when performing a comprehensive health assessment for adult patients with intellectual and developmental disabilities.
Health Checks Toolkit
The Health Checks for People with Learning Disabilities Toolkit, developed by the Royal College of General Practitioners (London, UK), provides guidance and resources to help physicians, practice nurses and the primary administration team organize and perform quality Health Checks on people with a developmental disability. The toolkit includes a health action plan template.
Learn how to implement these guideline recommendations into your practice from selected articles in the special issue on primary care of adults with intellectual and developmental disabilities in Canadian Family Physician, Vol 64 (suppl2): S1-78, April 2018:
Managing complexity in care of patients with intellectual and developmental disabilities
10. Hennen B, O’Driscoll T, Berg JM, Block W, Forster-Gibson C, Joyce D, et al. Preventive care checklist [PCC] – females. In: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011. p. 35-41.
11. Hennen B, O’Driscoll T, Berg JM, Block W, Forster-Gibson C, Joyce D, et al. Preventive care checklist [PCC] – males. In: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011. p. 35-41.
14. Grier L. Chapter 26: Medical home. In: Rubin IL, Merrick J, Greydanus DE, Patel DR, editors. Health care for people with intellectual and developmental disabilities across the lifespan. Rubin and Crocker 3rd ed. Springer; 2016. p. 289-300.
29. Royal College of General Practitioners [UK]. Learning disabilities: A step-by-step guide for GP practices [Website]. London, UK: Royal College of General Practitioners. Accessed 2017 Sep 25.
51. Lindsay P, Hoghton M. Chapter 28: Practicalities of care for adults with intellectual and developmental disabilities. In: Rubin IL, Merrick J, Greydanus DE, Patel DR, editors. Health care for people with intellectual and developmental disabilities across the lifespan. Rubin and Crocker 3rd ed. Springer; 2016. p. 313-34.
52. Byrne JH, Lennox NG, Ware RS. Systematic review and meta-analysis of primary healthcare interventions on health actions in people with intellectual disability. Journal of Intellectual and Developmental Disability. 2016;41(1):66-74.
53. Robertson J, Hatton C, Emerson E, Baines S. The impact of health checks for people with intellectual disabilities: An updated systematic review of evidence. Res Dev Disabil. 2014;35(10):2450-62.
54. Shooshtari S, Temple B, Waldman C, Abraham S, Ouellette-Kuntz H, Lennox N. Stakeholders’ perspectives towards the use of the comprehensive health assessment program (CHAP) for adults with intellectual disabilities in manitoba. J Appl Res Intellect Disabil. 2016.
55. Durbin J, Selick A, Casson I, Green L, Spassiani N, Perry A, et al. Evaluating the implementation of health checks for adults with intellectual and developmental disabilities in primary care: The importance of organizational context. Intellect Dev Disabil. 2016;54(2):136-50.
56. Sullivan WF, Cheetham T, Forster-Gibson C, Kelly M, Grier E, McDonell S, et al. Office organizational tips: Patients with developmental disabilities. In: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto ON Canada: Surrey Place & MUMS Guideline Clearing House; 2011. p. 21-3.
