Improving primary healthcare for people with developmental disabilities

Adults with intellectual and developmental disabilities (IDD) have more health issues than other adults, but they are less likely to receive preventative care. A new evidence-based toolkit, developed by Health Care Access Research and Developmental Disabilities Program (H-CARDD), will help family health teams provide better, more proactive care for this vulnerable and underserved population.

05/02/2016

 
Photo: Three people looking at the new Health Check toolkit; Copyright: CAMH/H-CARDD

The Health Check toolkit will help family health teams provide better, more proactive care for people with developmental disabilities, including autism; © CAMH/H-CARDD

"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 the Centre for Addiction and Mental Health (CAMH) and director of the H-CARDD program. "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."

Despite current Canadian guidelines that recommend adults with IDD receive an annual comprehensive assessment, including a physical exam, the majority of adults with IDD in Ontario are not receiving Health Checks. "Guidelines are not necessarily a product ready to be used in practice," said Dr. Lunsky. "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 toolkit was developed as part of a larger research study led by CAMH and Dr. Ian Casson, associate professor in the Department of Family Medicine at Queen's University, which analyzed how two Ontario family health teams implemented Health Checks for adults with IDD. The two clinical teams were St. Michael's Family Health Team based in Toronto with 70 staff physicians, and Queen's Family Health Team in Kingston with 25 staff physicians. Detailed study results were published today in Intellectual and Developmental Disabilities.

"Health Checks are like annual physicals, but they take into account the special needs of adults who have intellectual and developmental disabilities," said Dr. Casson who is also a family physician with Queen's Family Health Team. "They help such people get better access to health care, equivalent to people without disabilities, and they help family doctors recognize this population in their practices and serve them more effectively."

The toolkit includes a four step process to implement health checks, along with resources to help clinicians screen for IDD, clinical tools to assist with the exam itself, resources for patients and families, and examples of how the tools can be embedded into Electronic Medical Records for easier 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 physician with St. Michael's Family Health Team in Toronto. "Using this tool kit is a big step towards improving the physical health and well-being of adults with developmental disabilities.

The H-CARDD program, led by Dr. Lunsky at CAMH, has been studying the health and health care of over 66,000 adults with developmental disabilities in Ontario since 2010. In addition to describing health disparities faced by these adults, H-CARDD works closely with provincial stakeholders to translate research findings into changes in practice. The Health Check toolkit is the latest resource developed by the team to improve the health and healthcare of Ontarians with IDD.

"These are evidence-informed, clinically relevant tools that can help change practice and improve lives," said Dr. Lunsky. "We hope to see the Health Check toolkit go province-wide."

REHACARE.com; Source: Centre for Addiction and Mental Health

More about the Centre for Addiction and Mental Health at: www.camh.ca