Chronic disease management in patients with intellectual disabilities: a matched study in Dutch general practice

Bemd, Milou van den; Cuypers, Maarten; Schalk, Bianca; Leusink, Geraline L; Bischoff, Erik

doi:10.3399/bjgp.2023.0029

Cited by 2 publications

(1 citation statement)

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“…However, there appeared to be no difference between patients with intellectual disabilities and controls in receiving high numbers of prescriptions of inhalation medication per year (≥2), an indication of poor disease control, or in discussing smoking behaviour. In the group of patients with COPD who were not enroled, those with intellectual disabilities were more likely to receive >2 prescriptions of inhalation medication prescriptions than controls not enroled without intellectual disabilities (odds ratio 1.84) 43 . Enrolment in management programmes may therefore, for people with intellectual disabilities in particular, be an important way of controlling medication use and implementation of other interventions.…”

Section: Discussionmentioning

confidence: 98%

Asthma and COPD management of patients with intellectual disabilities in general practice

Mastebroek,

Everlo,

Cuypers

et al. 2024

npj Prim. Care Respir. Med.

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People with intellectual disabilities experience overall poorer health and healthcare access than the general population. It is largely unknown how this applies to asthma and chronic obstructive pulmonary disease (COPD) management by general practitioners (GPs). In a 10-year retrospective matched cohort study, n = 34,429, we examined year prevalence of asthma and COPD in adult patients with and without intellectual disabilities and potential differences in the delivery of asthma and COPD disease management activities in Dutch general practices (2010–2019). We collected information on patient characteristics, comorbidity, consultation patterns, use and outcomes of asthma/COPD control questionnaires, spirometry measurement, pulmonology referrals, and prescribed medication. Asthma patients with intellectual disabilities suffered more frequently from obesity (53.2% vs. 39.5% without intellectual disabilities), and both asthma and COPD patients with intellectual disabilities were more frequently current smokers (45.2% vs. 22.1% without intellectual disabilities, and 76.6% vs. 51.4% without intellectual disabilities, respectively). Also, a statistically significant larger number of asthma patients with intellectual disabilities were prescribed antibiotics (69.9% vs. 54.5%). COPD patients with intellectual disabilities, compared with matched controls without intellectual disabilities, received significantly more often either no COPD-related practice consultation at all (respectively 20.8% vs. 8.5%, p = 0.004) or a large number of practice consultations (>31 consultations, respectively 16.7% vs. 5.3%, p = 0.004). For asthma, there was no statistical difference between patients with or without intellectual disabilities regarding the number and type of consultations. The asthma year point prevalence in patients with intellectual disabilities was, from 2014 onward, significantly higher, and in 2019 was 8.7% vs. 6.0% for people without intellectual disabilities. For COPD, it was comparable in both groups. Both asthma and COPD patients with intellectual disabilities appeared considerably younger in age than patients without intellectual disabilities. Our findings warrant further research into the causes of the differences found for asthma and COPD and whether they also infer differences in the quality or the effectiveness of GP disease management, especially for young adults with intellectual disabilities.

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Section: Discussionmentioning

confidence: 98%