Improving the health of adults and young people with learning disabilities
Our researchers are enabling GPs to screen adults and young people with learning disabilities for a range of health conditions through an effective screening tool, the Cardiff Health Check.
People with an intellectual disability experience more health problems than the general population but they find it difficult to report their symptoms or the illness they experience. Cardiff University researchers developed the Cardiff Health Check which enables GPs to proactively screen for physical and mental health problems in adults with intellectual disabilities. This has lead to hundreds of thousands of people receiving Health Action Plans designed to improve their health and wellbeing after various health conditions were picked up through the Cardiff Health Check.
What is the Cardiff Health Check?
Prior to our research, there was no standardised health check for doctors to use to specifically screen people with intellectual disabilities. This meant that treatable illnesses frequently went undetected and there was a gap in care that resulted in reduced quality of life and significant early mortality. For example, men with intellectual disabilities die on average 13 years sooner than men in the general population, and women with intellectual disabilities die on average 20 years earlier than other women.
To address the urgent need for proactive health checking in adults with intellectual disabilities, Cardiff University researchers, led by professor Michael Kerr, developed and evaluated the Cardiff Health Check (also known as the Welsh Health Check).
This assessment tool allows GPs to conduct medication reviews and to proactively screen patients for various health indicators by measuring their weight, blood pressure, urine, smoking status, alcohol consumption and cholesterol. The Cardiff Health Check also considers immunizations, includes cervical and mammography screens, and measurement of respiratory, cardiovascular, abdominal, central nervous system function. It additionally covers medical issues common in intellectually disabled people, including epilepsy, behavioural disturbance, poor mobility and communication difficulties.
Following an evaluation of the Cardiff Health Check, the researchers found that nearly 50% of participants had unidentified health needs which required intervention and nearly 40% of individuals had two or more unmet health needs for example breathing difficulties, high blood pressure or breast cancer.
The researchers also confirmed that once GPs became aware of these health needs through conducting the Cardiff Health Check, they were more likely to offer support to manage these health conditions through ordering further tests, and referring patients to other specialist doctors. They found that 93% of previously unidentified health needs were acted on by GPs following a Cardiff Health Check.
An expansion of the Cardiff Health Check
Building on our research and evaluation findings, the Cardiff Health Check has been expanded to cover young people with intellectual disabilities (aged 14-18) in England as well as for adults with intellectual disabilities.
Additionally, a 2016 National Institute for Health and Care Excellence (NICE) Guideline called for the annual health check of intellectually disabled people to include a mental health review. Our researchers took this recommendation on board and extended the Cardiff Health Check to screen for mental health conditions as well as physical ones.
The Cardiff Health Check has been incorporated into a GP Digital Template in England and primary care services in England, Northern Ireland and Wales use the health check to monitor and screen their patients for a range of health conditions.
The extended Cardiff Health Check is helping to save lives as mortality rates are lower for people with intellectual disabilities who have the health check compared with those who do not.
- Cardiff researchers demonstrated an urgent need for proactive health checking in adults with intellectual disabilities.
- The Cardiff Health Check is a tool used by doctors to screen people with intellectual disabilities for a range of health problems so that the right treatments can be given to address any health conditions that are identified through the screening process.
- The Cardiff Health Check has been expanded to screen young people with intellectual disabilities and it has been extended to screen for mental health problems as well as physical conditions. This is helping many more intellectually disabled people get the right health care and treatment to live longer, healthier lives.
- Felce, D. J. et al. 2008. The impact of repeated health checks for adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities 21 (6), pp.585-596. (10.1111/j.1468-3148.2008.00441.x)
- Felce, D. J. et al. 2008. The impact of checking the health of adults with intellectual disabilities on primary care consultation rates, health promotion and contact with specialists. Journal of Applied Research in Intellectual Disabilities 21 (6), pp.597-602. (10.1111/j.1468-3148.2008.00432.x)
- Baxter, H. A. et al. 2006. Previously unidentified morbidity in patients with intellectual disability. British Journal of General Practice 56 (523), pp.93-98.