Management and prevalence of long‐term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population‐based cohort study

• Published in: Journal of applied research in intellectual disabilities Vol. 31; no. S1; pp. 68 - 81
• Main Authors: Cooper, Sally‐Ann, Hughes‐McCormack, Laura, Greenlaw, Nicola, McConnachie, Alex, Allan, Linda, Baltzer, Marion, McArthur, Laura, Henderson, Angela, Melville, Craig, McSkimming, Paula, Morrison, Jill
• Format: Journal Article
• Language: English
• Published: England Wiley-Blackwell 01.01.2018; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Adults; Chronic Disease - epidemiology; Chronic Disease - therapy; chronic disease management; Chronic Illness; Cohort analysis; Cohort Studies; Comorbidity; Comparative Analysis; Comparative studies; Diabetes; Disease Incidence; Diseases; Epilepsy; Female; Foreign Countries; general practice; health; Healthcare Disparities - standards; Healthcare Disparities - statistics & numerical data; Heart Disorders; Humans; Intellectual disabilities; Intellectual Disability; Intellectual Disability - epidemiology; Intellectual Disability - therapy; long‐term conditions; Male; Middle Aged; Outcome Assessment (Health Care) - standards; Outcome Assessment (Health Care) - statistics & numerical data; Population; Population-based studies; Prevalence; Primary Health Care; Primary Health Care - standards; Primary Health Care - statistics & numerical data; Psychosis; Registries - statistics & numerical data; Regression (Statistics); Reimbursement, Incentive; Scotland - epidemiology; Statistical Analysis; Young Adult; United Kingdom; health; primary health care; intellectual disabilities; chronic disease management; general practice; long-term conditions
• ISSN: 1360-2322; 1468-3148; 1468-3148
• DOI: 10.1111/jar.12386

Background In the UK, general practitioners/family physicians receive pay for performance on management of long‐term conditions, according to best‐practice indicators. Method Management of long‐term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long‐term conditions was determined, and associated factors were investigated via logistic regression analyses. Results Adults with intellectual disabilities received significantly poorer management of all long‐term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%–100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation. Conclusions Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care.