Health Checks for People with Learning Disabilities

Abstract

By offering annual health checks to people with learning disabilities a variety of health conditions were detected and treated. Health checks took place at a general practice surgery and were performed by a consultant psychiatrist in learning disability, a general practitioner (GP) and a community learning disability nurse. Thirty-five people attended full health checks at T1 (year 1) and T2 (a year later). Health status was quantified by measuring changes at T2. Contrary to other research findings, people with learning disabilities at this surgery consulted their GPs more frequently, were prescribed significantly more medication and were more likely to be prescribed medication than controls. At T1 33 (94 percent) people had a physical health problem that warranted intervention and 25 (71 percent) people had problems with their mental health. At T2 referrals and other interventions were reduced but still warranted extending the health checks into future years.

Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review

“…The majority of the studies investigated innovations within GP services. 19,[93][94][95][96][97][98][99][100][101][103][104][105][107][108][109][111][112][113] The remaining studies reported innovations in eye health, 92 in Improving Access to Psychological Therapies (IAPT), in cardiovascular disease 106 and for staff in care homes. 110 One of the included studies was a cluster randomised controlled trial, 100 but most had a cross-sectional design.…”

“…Twenty-three studies evaluated innovations developed to improve access. Fifteen of these studies 19,93,[95][96][97][98][99][100][101]104,105,[107][108][109]111 investigated health checks. Training for staff was investigated in five of the included studies.…”

“…Health checks were evaluated in 15 studies. These were found to help identify health needs, 93,101,107 improve the monitoring of people with long-term conditions, 121 reduce the long-term need for referral and interventions 96 and increase health promotion activities aimed at people with IDs. 19 Three studies 95,97,98 found that incentivisation schemes increased tests and checks and one study found health checks to be cost-effective.…”

Do health consultations for people with learning disabilities meet expectations? A narrative literature review

“…A study that combined health outcomes in terms of referrals, investigations and interventions with evaluation interviews identified clear evidence of health needs that were addressed, which highlights the importance of annual health checks (Cassidy, Martin, Martin, & Roy, ). Only 17 people with mild or moderate learning disabilities (of 42 who attended for a second health check) agreed to be interviewed about their experience immediately afterwards, and while most were positive “one said ‘not very much’, one thought the doctors were trying to hurt him, one indicated ‘no’ (followed by laughter) and one stated ‘don't worry I'm used to it’.” (Cassidy et al., , p. 130). Asking people with learning disabilities about health consultations can be affected by the setting and people who ask the questions (due to the perceived hierarchy of power between service users and doctors [Thompson, ; ]), resulting in not reporting their concerns.…”

“…A study that combined health outcomes in terms of referrals, investigations and interventions with evaluation interviews identified clear evidence of health needs that were addressed, which highlights the importance of annual health checks (Cassidy, Martin, Martin, & Roy, 2002). Only 17 people with mild or moderate learning disabilities (of 42 who attended for a second health check) agreed…”