Audit and comprehensive health assessment programme in the primary healthcare of adults with intellectual disability: a pilot study

International research has demonstrated significant shortcomings in the hea lth of adults with intellectual disability (ID). Because general practition ers (GPs) are the main providers of primary healthcare for this population, strategies to improve general practice care are an important aspect of rec tifying these shortcomings. The present pilot study aimed to determine the effect of various interventions on health maintenance activities and to ass ess their acceptability to GPs, with a view to informing larger scale studi es. The GPs were recruited through an earlier questionnaire-based postal su rvey. The GPs identified all their adult patients with ID, then obtained co nsent for participation from three patients randomly selected by the invest igators. The GPs completed two self-evaluation forms and case note audits 1 2 months apart, read a synopsis of the relevant literature provided by the researchers, and completed a comprehensive health assessment (CHA) of their three patients. Forty-five GPs agreed to participate in the CHA programme (CHAP), and 15 completed the project. Thirty-eight patients completed the p roject. The number of patient-GP dyads who completed the project was too sm all to demonstrate statistically significant changes in health issues over time. The GPs found that the synopsis of the literature was the best interv ention for increasing knowledge and was also the most practical to use in g eneral practice. The CHAP was the intervention that prompted the most actio n from the GP which would not have been undertaken otherwise. The CHAP appe ared to provide a superior review process compared to the other interventio ns used in the present study. The numbers of health maintenance activities found to be overdue and the number of health issues detected as a result of the process were considerable. The CHAP served as a communication tool and an educative instrument, providing a basis for future studies and strategi es to improve the general practice care of adults with ID.