title: Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial.
abstract: BACKGROUND
  People with intellectual disability constitute approximately 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.
authors.affiliation: Queensland Centre for Intellectual & Developmental Disability (QCIDD), School of Medicine, University of Queensland, Mater Hospitals, Raymond Terrace, South Brisbane 4101, Australia. n.lennox@uq.edu.au
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lennox
authors.forename: Christopher
authors.initials: C
authors.lastname: Bain
authors.forename: Therese
authors.initials: T
authors.lastname: Rey-Conde
authors.forename: David
authors.initials: D
authors.lastname: Purdie
authors.forename: Robert
authors.initials: R
authors.lastname: Bush
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pandeya
mesh_terms: D000328:Adult; D000368:Aged; D015982:Bias; D003191:Comprehensive Health Care / Q000379:methods; D003695:Delivery of Health Care / Q000379:methods; D003933:Diagnosis; D004185:Disability Evaluation; D005194:Family Practice / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods; D006304:Health Status; D006801:Humans; D007114:Immunization / Q000379:methods; D007360:Intelligence; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D011314:Preventive Health Services / Q000379:methods; D011793:Queensland / Q000453:epidemiology; D017678:Sex Distribution