Health actions prompted by health assessments for people with intellectual disability exceed actions recorded in general practitioners' records

2015 ◽  
Vol 21 (3) ◽  
pp. 317 ◽  
Author(s):  
Jacqueline H. Byrne ◽  
Robert S. Ware ◽  
Nicholas G. Lennox
Keyword(s):  
Intellectual Disability ◽  
General Practitioners ◽  
Health Assessment ◽  
Clinical Activity ◽  
Short Term ◽  
Assessment Program ◽  
Unmet Health Needs ◽  
Health Assessments ◽  
Comprehensive Health ◽  
Randomised Controlled

People with intellectual disability experience inadequate health care and have unmet health needs that can go unidentified or be poorly managed. Health assessments have been shown to significantly increase short-term clinical activity for people with intellectual disability. The aim of this study was to more accurately quantify the effect of health assessments for people with intellectual disability by comparing health actions recorded in health assessment booklets to actions recorded in general practitioners’ (GPs) records in the 12-month period following the health assessment. Participants were people with intellectual disability who had received a Comprehensive Health Assessment Program (CHAP), living in the community. The CHAP is a health assessment that is demonstrated to significantly increase health actions, compared with usual care, for people with intellectual disability. Data collected from three randomised controlled trials conducted in South-East Queensland, Australia, from 2000 to 2010 were pooled and analysed. The health assessment booklet contained significantly more information on health actions than GPs’ records. Notably, hearing tests (risk ratio (RR) = 5.9; 95% confidence interval (CI) = 4.7–7.4), breast checks (RR = 3.9; 95% CI = 2.7–5.7), and skin examinations (RR = 7.9; 95% CI = 5.9–10.7) were more likely to be recorded in the CHAP booklet. Health assessments increase health actions for people with intellectual disability to a significantly greater extent than previously demonstrated.

scholarly journals Estimation of a numerical value for joint damage-related physical disability in rheumatoid arthritis clinical trials

2009 ◽  
Vol 69 (6) ◽  
pp. 1058-1064 ◽  
Author(s):  
Josef S Smolen ◽  
Daniel Aletaha ◽  
Johannes C Grisar ◽  
Tanja A Stamm ◽  
John T Sharp
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Health Assessment ◽  
Joint Damage ◽  
Disease Activity Index ◽  
Controlled Clinical Trial ◽  
Short Term ◽  
Randomised Controlled ◽  
Radiographic Changes

BackgroundJoint damage is an important outcome in trials of rheumatoid arthritis (RA), usually assessed by Total Sharp Score (TSS). It is currently unknown how it translates numerically into disability by the Health Assessment Questionnaire (HAQ).ObjectiveTo determine the units of HAQ score corresponding to one TSS unit.MethodsA short-term observational trial of glucocorticoids in RA (the ‘BEst LIfe with Rheumatoid Arthritis’ (BELIRA) trial) was evaluated, using randomised controlled clinical trial (RCT) data for confirmation. For each trial arm HAQ, TSS and the Simplified Disease Activity Index (SDAI) were assessed. Based on the hypothesis that short-term HAQ changes will mostly be due to changes of disease activity, activity HAQ (ACT-HAQ) at end point (EP) was determined and remaining disability defined as damage related (DAM-HAQ). Using TSS at EP, the HAQ units corresponding to a TSS unit were estimated.ResultsIn BELIRA, one TSS unit corresponded to a mean of 0.017 HAQ units; to account for other causes of irreversible disability, the 25th percentile was used: 0.011 HAQ units/TSS unit. In RCT trial arms, the HAQ/TSS were similar (0.013 and 0.015 in established and early RA, respectively; 25th percentile: 0.010). The correlation between DAM-HAQEP and TSS was r=0.829. Over 5 years, damage would amount to an increase of irreversible HAQ of 0.33 on placebo, 0.13 on disease-modifying antirheumatic drugs (DMARDs) and 0.03 on TNF inhibitors+methotrexate (MTX).ConclusionAn approach to estimate the numerical relationship between HAQ and damage as 0.01 HAQ points/TSS unit is presented, although the linear relationship may not be generally valid. This allows the assessment of functional correlates of radiographic changes in trials.

scholarly journals Cross-Cultural Understanding of Health Assessments for People with Intellectual Disability: An Australian resource in the Philippines

2015 ◽  
Vol 8 (2) ◽  
pp. 1-9
Author(s):  
C. E. Brolan ◽  
M. T. Gomez ◽  
N. G. Lennox ◽  
R. S Ware
Keyword(s):  
Intellectual Disability ◽  
Assessment Tool ◽  
Health Assessment ◽  
People With Disabilities ◽  
The Philippines ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Comprehensive Health ◽  
Low And Middle Income

The Convention on the Rights of Persons with Disabilities has resulted in the involvement of high income countries in international development assistance to people with disabilities in low and middle income countries.  Healthcare tools designed in high income countries and delivered in low and middle income countries may not be appropriate to the context of the lives of people with disabilities.  We undertook a short qualitative study of participants’ views of an Australian-designed comprehensive health assessment tool, with participation from a WHO-Collaborating non-government organisation in regional Philippines. We also examined the participants’ perceptions of the barriers to healthcare for Filipinos with intellectual disabilities.  Responses to the comprehensive health assessment tool were positive although participants agreed that both linguistic and cultural translation would enhance wider use of the tool. The barriers identified included poverty, family isolation, stigma and communication issues as preventing appropriate healthcare delivery to Filipinos with intellectual disability. Consideration must be given to the complexities of transference of healthcare resources to a low and middle income country context, as well as the systemic and cultural barriers to appropriate healthcare provision to people with disabilities.

Children and young people in out-of-home care: are GPs ready and willing to provide comprehensive health assessments for this vulnerable group?

2010 ◽  
Vol 16 (4) ◽  
pp. 296 ◽  
Author(s):  
Susan M. Webster ◽  
Meredith Temple-Smith
Keyword(s):  
Home Care ◽  
Child Protection ◽  
Health Assessment ◽  
Policy Implications ◽  
Out Of Home Care ◽  
Health Assessments ◽  
Comprehensive Health ◽  
Depth Study ◽  
Professional Development Needs ◽  
Training Professional

Children living in out-of-home care because of abuse or neglect are among the most vulnerable in Australia. In 2005 the Royal Australasian College of Physicians highlighted the need for increased attention to the health of such children and recommended regular health assessment. This qualitative study explored the views of a purposive sample of 20 GPs about what would influence GP willingness and readiness to undertake comprehensive health assessments for children entering out-of-home care. Ethical concerns, training, professional development needs, medico-legal issues, workforce and financial pressures and communication problems with the child protection sector were among key factors identified. Professional values about continuity of health care for children emerged as a new issue with important policy implications. This is the first in-depth study in Australia of GP perspectives about systematic health assessments for children in child protection and sheds new light on the low GP uptake of such assessments for at-risk population groups.

Sign in / Sign up

Export Citation Format

Share Document