Compared to other adults, those with intellectual and developmental disabilities (IDD) have more health problems but are less likely to have access to preventative care. One strategy that has seen success in increasing prevention and early detection of illness is a periodic comprehensive health assessment (the health check).
A new tool kit, advanced by the Health Care Access Research and Developmental Disabilities Program (H-CARDD), can improve healthcare for people with developmental disabilities such as cerebral palsy.
The study, “Evaluating the Implementation of Health Checks for Adults With Intellectual and Developmental Disabilities in Primary Care: The Importance of Organizational Context,” was published in the journal Intellectual and Developmental Disabilities.
“Right now too many people with developmental disabilities are not getting the routine care they need, and this can lead to crisis and emergency room visits,” said Dr. Yona Lunsky, clinician-scientist at Canada’s Centre for Addiction and Mental Health (CAMH) and director of the H-CARDD program, in a news release. “If you can improve the quality of care upstream at the primary care level, then you can address health issues early and prevent more serious health issues from emerging.”
Canadian guidelines recommend adults with IDD receive an annual assessment. But in Ontario, most people with developmental disabilities are not getting their health checks.
“Guidelines are not necessarily a product ready to be used in practice,” Lunsky said. “We needed something to help bridge that gap and make it easier for busy family health teams to implement these guidelines into everyday practice and improve care.”
The study evaluated the implementation of the health check at two primary-care clinics in Ontario, and the influence of the clinical context on implementation decisions. The study was developed as part of a project headed by CAMH and Dr. Ian Casson.
“Health checks are like annual physicals, but they take into account the special needs of adults who have intellectual and developmental disabilities,” said Casson, associate professor in the Department of Family Medicine at Queen’s University and a family physician with Queen’s Family Health Team. “They help such people get better access to healthcare, equivalent to people without disabilities, and they help family doctors recognize this population in their practices and serve them more effectively.”
The tool kit comprises a four-step health check implementation process and resources to help physicians screen for IDD, as well as clinical instruments to support the clinical assessment, resources for patients and their families, and illustrations of how the tools can be inserted into electronic medical records for simpler access.
“Family physicians have the ability to provide excellent, guideline-directed care to adults with developmental disabilities, but have been hampered by ways to identify this population in their practice,” said Dr. Laurie Green, a physician with St. Michael’s Family Health Team in Toronto. “Using this tool kit is a big step toward improving the physical health and well-being of adults with developmental disabilities.”
Since 2010, the H-CARDD program, headed by Lunsky at CAMH, has been studying the health status and healthcare of more than 66,000 adults with developmental disabilities in Ontario. H-CARDD involves scientists, clinicians, service providers, policymakers, and people with developmental disabilities. The health check tool kit is the newest resource advanced by the team to improve the health and healthcare of people with IDD.
“These are evidence-informed, clinically relevant tools that can help change practice and improve lives,” Lunsky said. “We hope to see the health check tool kit go province-wide.”