Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial

Int J Epidemiol. 2007 Feb;36(1):139-46. doi: 10.1093/ije/dyl254. Epub 2007 Jan 11.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bias
  • Comprehensive Health Care / methods
  • Delivery of Health Care / methods
  • Diagnosis
  • Disability Evaluation*
  • Family Practice / methods
  • Female
  • Health Promotion / methods
  • Health Status
  • Humans
  • Immunization / methods
  • Intelligence
  • Male
  • Mental Disorders / complications
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Preventive Health Services / methods
  • Queensland / epidemiology
  • Sex Distribution