IJE Advance Access originally published online on January 11, 2007
International Journal of Epidemiology 2007 36(1):139-146; doi:10.1093/ije/dyl254
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Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial
1 Queensland Centre for Intellectual & Developmental Disability (QCIDD), School of Medicine, University of Queensland, Mater Hospitals, Raymond Terrace, South Brisbane 4101, Australia.
2 School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006, Australia.
3 Queensland Institute of Medical Research, Herston Road, Herston, Queensland, 4006, Australia.
4 Northern California Cancer Center, 32960 Alvarado-Niles Road, Suite 600, Union City, CA 94587, U.S.A.
The Corresponding author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non-exclusive for government employees) on a worldwide basis to the International Journal of Epidemiology to permit this article (if accepted) to be published in IJE editions, products and exploit all subsidiary rights.
* Corresponding author. Queensland Centre for Intellectual & Developmental Disability (QCIDD), Mater Hospitals, Community Services Building, Raymond Terrace, South Brisbane 4101, Australia. E-mail: n.lennox{at}uq.edu.au
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Abstract |
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Background People with intellectual disability constitute 
2% of the population. They die prematurely, and often have a number of unrecognized or poorly managed medical conditions as well as inadequate health promotion and disease prevention.
Methods A cluster randomized controlled trial with matched pairs was carried out. The participants were adults with intellectual disability (n = 453 in 34 clusters). The intervention was a health assessment programme to enhance interactions between the adult with intellectual disability, their carer and their general practitioner (GP). It prompted the systematic gathering of a health history and, subsequently, access to a GP for a guided health review and development of a health action plan. It also provided information about the health of adults with intellectual disability. Follow-up was for 1 year post intervention, with outcomes extracted from GPs’ clinical records.
Results Increased health promotion, disease prevention and case-finding activity was found in the intervention group. Compared with the control group there was a 6.6-fold increase in detection of vision impairment (95% confidence interval 1.9–40); a 30-fold increase in hearing testing (4.0–230); an increase in immunization updates [tetanus/diphtheria a 9-fold increase (4.2–19)], and improvements in women's health screening [Papanicolau smears were eight times more common (1.8–35)]. The intervention increased detection of new disease by 1.6 times (0.9–2.8).
Conclusions The Comprehensive Health Assessment Program (CHAP) produced a substantial increase in GPs’ attention to the health needs of adults with intellectual disability with concomitantly more disease detection. The presumption that these will yield longer-term health benefits, while suggestive, remains unexamined.
Keywords Intellectual disability, general practitioners, health assessment
Accepted 21 October 2006