| Titre : | Effects of a comprehensive health assessment programme for Australian adults with intellectual disability : a cluster randomized trial. Commentary. (2007) |
| Auteurs : | Nicholas LENNOX ; Christopher BAIN ; Robert BUSH ; Hélène OUELLETTE-KUNTZ ; Nirmala PANDEYA ; PURDIE (David) : USA. Northern California Cancer Center. Union City. CA. ; Therese REY-CONDE ; Queensland Institute of Medical Research. Herston Queensland. AUS ; University of Queensland. Mater Hospitals Raymond Terrace. School of Medicine. Queensland Centre for Intellectual & Developmental Disability. (Q.C.I.D.D.). South Brisbane. AUS |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 36, n° 1, 2007) |
| Pagination : | 139-148 |
| Langues: | Anglais |
| Mots-clés : | Retard mental ; Promotion santé ; Programme santé ; Médecin généraliste ; Australie ; Adulte ; Océanie ; Homme |
| Résumé : | [BDSP. Notice produite par INIST-CNRS s4R0xC1x. Diffusion soumise à autorisation]. 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. |
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