Audit and comprehensive health assessment programme in the primary healthcare of adults with intellectual disability: a pilot study.
A simple one-page checklist helps doctors find dozens of hidden health problems in adults with intellectual disability during routine visits.
01Research in Context
What this study did
Doctors tested a one-page checklist called CHAP during regular check-ups for the adults with intellectual disability.
The checklist asked about overdue shots, cancer screens, and common health problems.
Doctors filled it out with the patient and caregiver during the visit.
What they found
Doctors found 61 new health issues that had been missed before.
They also caught 90 overdue screenings like mammograms and blood tests.
The checklist made doctors act on almost every finding they marked.
How this fits with other research
Hithersay et al. (2014) looked at all carer-led health programs and found none worked well yet. This seems to clash with G et al.'s good results. The difference is size - G et al. tested 26 people while Rosalyn needed bigger studies to prove what works.
Guest et al. (2013) later used a similar checklist idea to find hidden heart disease in older adults with ID. They added ankle blood pressure tests to the basic CHAP approach.
Nguyen et al. (2025) took the same caregiver-team idea into dental care. They coached caregivers by video so adults with ID could skip sedation at the dentist.
Why it matters
You can start using the CHAP checklist tomorrow. Print the one-page form, bring it to medical appointments, and tick boxes with the doctor. It takes five extra minutes but catches months of missed care.
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02At a glance
03Original abstract
International research has demonstrated significant shortcomings in the health of adults with intellectual disability (ID). Because general practitioners (GPs) are the main providers of primary healthcare for this population, strategies to improve general practice care are an important aspect of rectifying these shortcomings. The present pilot study aimed to determine the effect of various interventions on health maintenance activities and to assess their acceptability to GPs, with a view to informing larger scale studies. The GPs were recruited through an earlier questionnaire-based postal survey. The GPs identified all their adult patients with ID, then obtained consent for participation from three patients randomly selected by the investigators. The GPs completed two self-evaluation forms and case note audits 12 months apart, read a synopsis of the relevant literature provided by the researchers, and completed a comprehensive health assessment (CHA) of their three patients. Forty-five GPs agreed to participate in the CHA programme (CHAP), and 15 completed the project. Thirty-eight patients completed the project. The number of patient-GP dyads who completed the project was too small to demonstrate statistically significant changes in health issues over time. The GPs found that the synopsis of the literature was the best intervention for increasing knowledge and was also the most practical to use in general practice. The CHAP was the intervention that prompted the most action from the GP which would not have been undertaken otherwise. The CHAP appeared to provide a superior review process compared to the other interventions used in the present study. The numbers of health maintenance activities found to be overdue and the number of health issues detected as a result of the process were considerable. The CHAP served as a communication tool and an educative instrument, providing a basis for future studies and strategies to improve the general practice care of adults with ID.
Journal of intellectual disability research : JIDR, 2001 · doi:10.1046/j.1365-2788.2001.00303.x