title: Primary care of adults with developmental disabilities: Canadian consensus guidelines.
abstract: OBJECTIVE
  To update the 2006 Canadian guidelines for primary care of adults with developmental disabilities (DD) and to make practical recommendations based on current knowledge to address the particular health issues of adults with DD.
  
  
  METHODS
  Knowledgeable health care providers participating in a colloquium and a subsequent working group discussed and agreed on revisions to the 2006 guidelines based on a comprehensive review of publications, feedback gained from users of the guidelines, and personal clinical experiences. Most of the available evidence in this area of care is from expert opinion or published consensus statements (level III).
  
  
  RESULTS
  Adults with DD have complex health issues, many of them differing from those of the general population. Good primary care identifies the particular health issues faced by adults with DD to improve their quality of life, to improve their access to health care, and to prevent suffering, morbidity, and premature death. These guidelines synthesize general, physical, behavioural, and mental health issues of adults with DD that primary care providers should be aware of, and they present recommendations for screening and management based on current knowledge that practitioners can apply. Because of interacting biologic, psychoaffective, and social factors that contribute to the health and well-being of adults with DD, these guidelines emphasize involving caregivers, adapting procedures when appropriate, and seeking input from a range of health professionals when available. Ethical care is also emphasized. The guidelines are formulated within an ethical framework that pays attention to issues such as informed consent and the assessment of health benefits in relation to risks of harm.
  
  
  CONCLUSIONS
  Implementation of the guidelines proposed here would improve the health of adults with DD and would minimize disparities in health and health care between adults with DD and those in the general population.
authors.affiliation: St Michael's Hospital, Toronto, Ont. bill.sullivan@surreyplace.on.ca
authors.forename: William F
authors.initials: WF
authors.lastname: Sullivan
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Berg
authors.forename: Elspeth
authors.initials: E
authors.lastname: Bradley
authors.forename: Tom
authors.initials: T
authors.lastname: Cheetham
authors.forename: Richard
authors.initials: R
authors.lastname: Denton
authors.forename: John
authors.initials: J
authors.lastname: Heng
authors.forename: Brian
authors.initials: B
authors.lastname: Hennen
authors.forename: David
authors.initials: D
authors.lastname: Joyce
authors.forename: Maureen
authors.initials: M
authors.lastname: Kelly
authors.forename: Marika
authors.initials: M
authors.lastname: Korossy
authors.forename: Yona
authors.initials: Y
authors.lastname: Lunsky
authors.forename: Shirley
authors.initials: S
authors.lastname: McMillan
mesh_terms: D000328:Adult; D002170:Canada; D002658:Developmental Disabilities / Q000628:therapy; D006801:Humans; D011320:Primary Health Care