Barriers and enablers to optimal diabetes care for adults with learning disabilities: A systematic review

Abstract

Accessible Summary Adults with learning disabilities and diabetes are more likely to have health problems than people with diabetes who do not have learning disabilities. This research had two aims. One was to find out what stops adults with learning disabilities from getting help with their diabetes. The other was to find out what things help them get the best care for their diabetes. We found 12 things that stop adults with learning disabilities from getting good care for their diabetes and 14 things that help them get good care. The findings from this research can be used to improve the lives of adults living with learning disabilities and diabetes. Abstract Background Individuals with diabetes and a learning disability have poorer health outcomes than those without a learning disability. In the UK, the health inequalities faced by people with learning disabilities are often the result of barriers they face in accessing timely, appropriate and effective health care. The aim of the study was to review relevant literature to identify the barriers and enablers to optimal diabetes care for adults with learning disabilities. Methods Systematic review methodology was used to answer the research question: What barriers and enablers to optimal diabetes care exist for adults with learning disabilities? This review is reported according to PRISMA guidelines. Key databases were searched using relevant terms. Included studies were synthesised using thematic analysis and were quality appraised. Findings This review identified 12 barriers to optimal diabetes care for adults with learning disabilities and 14 enablers to optimal care from 10 diverse publications. Low level of diabetes knowledge and understanding and systems that do not allow reasonable adjustments were the barriers considered to have the greatest reliability. The enabler identified to have the highest reliability was person‐centred planning and reasonable adjustments. Conclusion This work highlights key actions that can be undertaken to address inequalities in diabetes care for people with learning disabilities. With additional research in this field, further progress can be made to improve the lives of those adults living with learning disabilities and diabetes.

Records of quality indicators for management of long‐term health conditions of patients with intellectual disabilities in Dutch residential care

“…adjustments (Holden & Lee, 2022). Healthcare professionals can be discouraged from appropriately registering all quality indicators due to issues such as high administrative burden in care for people with intellectual disabilities (Weise et al, 2017), low experienced userfriendliness of health information systems, such as the one used in this study (van der Beek, 2016), and difficulties in collaboration across care organisations due to the use of different electronic patient records (Tummers et al, 2021).…”

“…Difficulties in performing clinical examinations in people with intellectual disabilities (Navas et al, 2019; O'Neill et al, 2019; Pouls et al, 2009; Van De Louw et al, 2009) often result in GPs having to choose which aspects of disease management are most important to tackle short‐term rather than establishing more long‐term goals. On the other hand, information systems may be too elaborate for care for people with intellectual disabilities, and they often do not allow for reasonable adjustments (Holden & Lee, 2022). Healthcare professionals can be discouraged from appropriately registering all quality indicators due to issues such as high administrative burden in care for people with intellectual disabilities (Weise et al, 2017), low experienced user‐friendliness of health information systems, such as the one used in this study (van der Beek, 2016), and difficulties in collaboration across care organisations due to the use of different electronic patient records (Tummers et al, 2021).…”

The barriers and facilitators to managing diabetes with insulin in adults with intellectual disabilities: A systemised review of the literature

“…This is consistent with the findings of Maine et al (2017), and Holden and Lee's ( 2021) systematic review about the barriers and enablers to optimal diabetes care for adults with intellectual disabilities. Holden and Lee (2021) found that current structured group education courses are not appropriate to the learning needs of adults with intellectual disabilities. Adapted programmes, such as DESMOND-ID for people with type 2 diabetes and intellectual disabilities have been developed (Taggart et al, 2018), but such programmes are not available nationally (Maine et al, 2017).…”