Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines

William F Sullivan¹, Heidi Diepstra², John Heng³, Shara Ally⁴, Elspeth Bradley⁵, Ian Casson⁶, Brian Hennen⁷, Maureen Kelly⁸, Marika Korossy⁹, Karen McNeil¹⁰, Dara Abells¹¹, Khush Amaria¹², Kerry Boyd¹³, Meg Gemmill¹⁴, Elizabeth Grier¹⁴, Natalie Kennie-Kaulbach¹⁵, Mackenzie Ketchell¹⁶, Jessica Ladouceur¹⁷, Amanda Lepp¹⁸, Yona Lunsky¹⁹, Shirley McMillan²⁰, Ullanda Niel²¹, Samantha Sacks²², Sarah Shea²³, Katherine Stringer²⁴, Kyle Sue²⁵, Sandra Witherbee²⁶

Affiliations

¹ Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario, a staff physician in Medical Services at Surrey Place Centre and the Family Practice Unit at St Michael's Hospital, and Director of the Developmental Disabilities Primary Care Program at Surrey Place Centre. bill.sullivan@utoronto.ca.
² Research associate at Surrey Place Centre.
³ Assistant Professor in the Department of Philosophy and the Department of Interdisciplinary Studies at King's University College in London, Ont.
⁴ An advanced practice nurse at Surrey Place Centre, Adjunct Lecturer in the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto, and an MBA candidate.
⁵ Associate Professor in the Department of Psychiatry at the University of Toronto and a consulting psychiatrist and psychotherapist in intellectual disabilities.
⁶ Associate Professor in the Department of Family Medicine at Queen's University in Kingston, Ont.
⁷ Professor Emeritus at Western University in London and Dalhousie University in Halifax, NS.
⁸ Retired nurse from Toronto.
⁹ Retired librarian from Surrey Place Centre in Toronto.
¹⁰ Assistant Professor in the Department of Family Medicine at Dalhousie University.
¹¹ Family physician at Forest Hill Family Health Centre in Toronto and the Integrated Services for Autism and Neurodevelopmental Disorders, and Lecturer in the Department of Family and Community Medicine at the University of Toronto.
¹² Clinical and health psychologist and team lead for the Good 2 Go Transition Program at the Hospital for Sick Children in Toronto.
¹³ Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ont, and Chief Clinical Officer for Bethesda Community Services in Thorold, Ont.
¹⁴ Assistant Professor in the Department of Family Medicine at Queen's University.
¹⁵ University Teaching Fellow and a coordinator in the Skills Lab in the College of Pharmacy at Dalhousie University.
¹⁶ Behaviour analyst and Professor in the School of Social and Community Services at Humber Institute of Technology and Advanced Learning in Toronto.
¹⁷ Adjunct Professor in the Belleville Queen's University Family Medicine Centre.
¹⁸ Resident in the Discipline of Family Medicine at McMaster University.
¹⁹ Senior Scientist at the Centre for Addiction and Mental Health in Toronto and Professor and Developmental Disability Lead at the University of Toronto.
²⁰ Clinical nurse specialist in the adult program at Surrey Place Centre.
²¹ Family physician at the Scarborough Centre for Healthy Communities in Ontario.
²² Clinical Faculty Lecturer in the Department of Family Medicine at McGill University in Montreal, Que, and a family physician at See Things My Way Centre for Innovation in Autism and Intellectual Disabilities.
²³ Professor in the Department of Pediatrics at Dalhousie University.
²⁴ Associate Professor and Chair of Family Medicine at Memorial University of Newfoundland in St John's.
²⁵ Clinical Assistant Professor in the Discipline of Family Medicine at Memorial University of Newfoundland.
²⁶ Family practice nurse in the Dalhousie Family Medicine Clinic.

PMID: 29650602
PMCID: PMC5897068

Practice Guideline

Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines

William F Sullivan et al. Can Fam Physician. 2018 Apr.

. 2018 Apr;64(4):254-279.

Authors

Affiliations

¹ Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario, a staff physician in Medical Services at Surrey Place Centre and the Family Practice Unit at St Michael's Hospital, and Director of the Developmental Disabilities Primary Care Program at Surrey Place Centre. bill.sullivan@utoronto.ca.
² Research associate at Surrey Place Centre.
³ Assistant Professor in the Department of Philosophy and the Department of Interdisciplinary Studies at King's University College in London, Ont.
⁴ An advanced practice nurse at Surrey Place Centre, Adjunct Lecturer in the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto, and an MBA candidate.
⁵ Associate Professor in the Department of Psychiatry at the University of Toronto and a consulting psychiatrist and psychotherapist in intellectual disabilities.
⁶ Associate Professor in the Department of Family Medicine at Queen's University in Kingston, Ont.
⁷ Professor Emeritus at Western University in London and Dalhousie University in Halifax, NS.
⁸ Retired nurse from Toronto.
⁹ Retired librarian from Surrey Place Centre in Toronto.
¹⁰ Assistant Professor in the Department of Family Medicine at Dalhousie University.
¹¹ Family physician at Forest Hill Family Health Centre in Toronto and the Integrated Services for Autism and Neurodevelopmental Disorders, and Lecturer in the Department of Family and Community Medicine at the University of Toronto.
¹² Clinical and health psychologist and team lead for the Good 2 Go Transition Program at the Hospital for Sick Children in Toronto.
¹³ Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ont, and Chief Clinical Officer for Bethesda Community Services in Thorold, Ont.
¹⁴ Assistant Professor in the Department of Family Medicine at Queen's University.
¹⁵ University Teaching Fellow and a coordinator in the Skills Lab in the College of Pharmacy at Dalhousie University.
¹⁶ Behaviour analyst and Professor in the School of Social and Community Services at Humber Institute of Technology and Advanced Learning in Toronto.
¹⁷ Adjunct Professor in the Belleville Queen's University Family Medicine Centre.
¹⁸ Resident in the Discipline of Family Medicine at McMaster University.
¹⁹ Senior Scientist at the Centre for Addiction and Mental Health in Toronto and Professor and Developmental Disability Lead at the University of Toronto.
²⁰ Clinical nurse specialist in the adult program at Surrey Place Centre.
²¹ Family physician at the Scarborough Centre for Healthy Communities in Ontario.
²² Clinical Faculty Lecturer in the Department of Family Medicine at McGill University in Montreal, Que, and a family physician at See Things My Way Centre for Innovation in Autism and Intellectual Disabilities.
²³ Professor in the Department of Pediatrics at Dalhousie University.
²⁴ Associate Professor and Chair of Family Medicine at Memorial University of Newfoundland in St John's.
²⁵ Clinical Assistant Professor in the Discipline of Family Medicine at Memorial University of Newfoundland.
²⁶ Family practice nurse in the Dalhousie Family Medicine Clinic.

PMID: 29650602
PMCID: PMC5897068

Abstract

Objective: To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD).

Methods: Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations.

Recommendations: Adults with IDD are a heterogeneous group of patients and have health conditions and factors affecting their health that can vary in kind, manifestation, severity, or complexity from those of others in the community. They require approaches to care and interventions that are adapted to their needs. These guidelines provide advice regarding standards of care. References to clinical tools and other practical resources are incorporated. The approaches to care that are outlined here can be applied to other groups of patients that have impairments in cognitive, communicative, or other adaptive functioning.

Conclusion: As primary care providers, family physicians play a vital role in promoting the health and well-being of adults with IDD. These guidelines can aid their decision making with patients and caregivers.

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References

1. Sullivan WF, Berg JM, Bradley E, Cheetham T, Denton R, Heng J, et al. Primary care of adults with developmental disabilities. Canadian consensus guidelines. Can Fam Physician. 2011;57:541–53. (Eng), e154–68 (Fr) - PMC - PubMed
1. Brown I, Wehmeyer ML, Shogren KA. What is meant by the terms intellectual disability and developmental disabilities? In: Wehmeyer ML, Brown I, Percy M, Shogren KA, Fung WLA, editors. A comprehensive guide to intellectual and developmental disabilities. 2nd ed. Baltimore, MD: Brookes; 2017. pp. 7–18.
1. Balogh RS, Wood JR, Lunsky Y, Ouellette-Kuntz HMJ, Wilton AS, Cobigo V, et al. Chronic disease management. In: Lunsky Y, Klein-Geltink JE, Yates EA, editors. Atlas on the primary care of adults in Ontario. Toronto, ON: Centre for Addiction and Mental Health, Institute for Clinical Evaluative Sciences; 2013. pp. 92–116. Available from: www.porticonetwork.ca/documents/38160/99698/Atlas+revised+2014/c2d68a41-.... Accessed 2015 Dec 8.
1. Shaw E, Oandasan I, Fowler N, editors. CanMEDS–Family Medicine, 2017: a competency framework for family physicians across the continuum. Mississauga, ON: College of Family Physicians of Canada; 2017. Available from: www.cfpc.ca/uploadedFiles/Resources/Resource_Items/Health_Professionals/.... Accessed 2018 Feb 9.
1. Salvador-Carulla L, Lukersmith S, Sullivan W. From the EBM pyramid to the Greek temple: a new conceptual approach to guidelines as implementation tools in mental health. Epidemiol Psychiatr Sci. 2017;26(2):105–14. - PMC - PubMed

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Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines

Affiliations

Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials