Consensus guidelines for primary health care of adults with developmental disabilities.
OBJECTIVE
To develop practical Canadian guidelines for primary health care providers based on the best available evidence for addressing health issues in adults with developmental disabilities (DD).


METHODS
Authors of background papers synthesized information from their own clinical experience, from consultations with other experts, and from relevant professional publications. Based on discussions of these papers at a colloquium of knowledgeable health care providers, a consensus statement was developed. Standard criteria were used to select guidelines for consideration and to rank evidence supporting them. Most evidence was level III.


RESULTS
People with DD have complex health issues, some differing from those of the general population. Adequate primary health care is necessary to identify these issues and to prevent morbidity and premature death. Physical, behavioural, and mental health difficulties should be addressed, and primary health care providers should be particularly attentive to the interactions of biological, psychological, and social factors contributing to health, since these interactions can easily be overlooked in adults with DD. Attention must also be paid to such ethical issues as informed consent and avoidance of harm. Developmental disabilities are not grounds for care providers to withhold or to withdraw medically indicated interventions, and decisions concerning such interventions should be based on patients' best interests.


CONCLUSIONS
Implementing the guidelines proposed here would improve the health of adults with DD and minimize disparities in health and health care.
Sullivan
William F
WF
St Michael's Hospital and Surrey Place Centre, Toronto, Ontario, Canada. bill.sullivan@utoronto.ca
Heng
John
J
Cameron
Donna
D
Lunsky
Yona
Y
Cheetham
Tom
T
Hennen
Brian
B
Bradley
Elspeth A
EA
Berg
Joseph M
JM
Korossy
Marika
M
Forster-Gibson
Cynthia
C
Gitta
Maria
M
Stavrakaki
Chrissoula
C
McCreary
Bruce
B
Swift
Irene
I
D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D011320:Primary Health Care / Q000592:standards*