Improving the health of people with intellectual disabilities: outcomes of a health screening programme after 1 year

Abstract

This is the first study to demonstrate sustained benefits in health outcomes from a clinical intervention for adults with IDs compared with standard treatment alone. Its routine implementation is feasible, and would reduce health inequalities.

Practice nurse health checks for adults with intellectual disabilities: a cluster-design, randomised controlled trial

“…The intervention was less effective than the previous Scottish intervention study, 18 in which health checks were undertaken by intellectual disabilities nurses rather than practice nurses, and took about five times longer. The follow-up duration was also longer in that study (1 year) compared with our study (9 months).…”

“…For 90% power and 5% significance, the previous Scottish intervention study 18 showed that 51 participants would be needed in each group to detect a rise in the proportion of new health needs being met, from a third to two-thirds (nQuery Advisor v 4.0, based on a continuity-corrected χ 2 test); or 64 in each study group allowing for 20% attrition. The amount of inflation in sample size needed because of the cluster-randomised design depends on the average cluster size (expected to be 2.5 in this investigation) and intraclass correlation coefficient (ICC).…”

“…We had no information from which to estimate the ICC, but by assuming a value of 0.05, the increase in sample size needed would be less than 10%. Furthermore, the previous study 18 used a more detailed health-check instrument, and since then accessibility of primary care might have improved. We therefore cautiously aimed to recruit 75 participants per group.…”

“…This route is a 3 year course that does not require a previous nursing qualification, and is different from the role of nurse practitioners or liaison nurses. A non-randomised intervention study 18 in Scotland investigated 50 adults with intellectual disabilities who were health checked by intellectual disabilities nurses, matched for sex, age, and ability, and 50 who received treatment as usual (standard care). After 1 year, the intervention group had substantially more health, health monitoring, and healthpromotion needs met, and the intervention was inexpensive.…”

“…After 1 year, the intervention group had substantially more health, health monitoring, and healthpromotion needs met, and the intervention was inexpensive. 18,19 However, the health check took 4 h, and outcomes might have been improved with health checks done by GPs or practice nurses, since the study identified predominantly general health needs. An Australian trial randomly assigned 453 adults receiving paid support from one provider, into 34 clusters.…”