The impact of health checks for people with intellectual disabilities: An updated systematic review of evidence

Abstract

Health checks for people with intellectual disabilities have been recommended as one component of international health policy responses to the poorer health of people with intellectual disabilities. This review updates a previously published review summarising evidence on the impact of health checks on the health and well-being of people with intellectual disabilities. Electronic literature searches and email contacts were used to identify literature relevant to the impact of health checks for people with intellectual disabilities published from 1989 to 2013. Forty-eight publications were identified, of which eight articles and two reports were newly identified and not included in the previous review. These involved checking the health of people with intellectual disabilities from a range of countries including a full range of people with intellectual disabilities. Health checks consistently led to detection of unmet health needs and targeted actions to address health needs. Health checks also had the potential to increase knowledge of the health needs of people with intellectual disabilities amongst health professionals and support staff, and to identify gaps in health services. Health checks are effective in identifying previously unrecognised health needs, including life threatening conditions. Future research should consider strategies for optimising the cost effectiveness or efficiency of health checks.

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

“…The Learning Disabilities Observatory undertook a systematic review of the evidence base for annual health checks in 2011, 11 subsequently updated in 2014, 12 which summarised health gains and impacts from similar interventions both in the UK and internationally. The initial review identified 38 studies (45 in the later review) that comprised a total of > 5000 individuals receiving a health check.…”

“…These conclusions are also supported by the larger number of uncontrolled studies. 11,12 Evidence on health outcomes relating to health checks is far more limited and of poorer quality. Uncontrolled studies in the UK have reported a variety of benefits of health checks, including improved seizure control and weight management.…”

“…One larger before-and-after study of a domiciliary preventative intervention in the USA found a reduction in self-reported pain, falls and emergency room visits, 37 whereas another larger US study suggested that health screening may help to resolve psychiatric problems by identifying physical problems. 38 The systematic reviews by Robertson et al 11,12 concluded that there was limited evidence on the effect of health checks on health status and that further work was required to establish the effectiveness of health checks. It is highly plausible that health checks, through identifying unmet health needs and preventative interventions, will lead to an improvement in health outcomes, but evidence to confirm this is important.…”

“…As the evidence base suggests that health checks improve the detection of unmet health needs, the management of chronic disease and the uptake of preventative care, 12 the possible longer-term health benefits of health checks may occur across a range of conditions, such as better seizure control in epilepsy, reduced cardiovascular risk and the early treatment or prevention of infection. For all of these conditions, delayed, incomplete or poor management will lead to an emergency hospital admission.…”

“…10 Recent systematic reviews have confirmed that health checks are effective in identifying health problems but found a paucity of evidence on their impact on health status and outcomes, 11 and have stated the need for an increase in quantity and quality of research on health interventions for people with ID. 12 This study, therefore, aims to fill key knowledge gaps with a large sample evaluation of the effectiveness of annual health checks and a comprehensive study of health and health care in a national sample of adults with ID.…”