Quality improvement of physical health monitoring for people with intellectual disabilities: an integrative review

People with intellectual disabilities (ID) have decreased longevity and experience a different chronic health profile compared with the general population (Heslop & Glover 2015). In the UK, people with ID die sooner than their non-disabled counterparts and on average experience 5–6 co-morbidities including cardiovascular disease, diabetes, respiratory disease and dysphagia (Shavell & Strauss 1999; Emerson & Baines 2010). Many conditions are either undetected or poorly managed by healthcare services (van Schrojenstein Lantman-De Valk et al. 2000). A quarter of deaths are subsequently considered preventable (Oullette-Kuntz 2005). These represent a significant health inequality and are an international cause for concern (Beange et al. 1995; Oullette-Kuntz et al. 2005; Krahn et al. 2006; Emerson & Baines 2010). Although healthcare professionals are well placed to address unmet physical health needs of clients, a lack of knowledge has been identified as a barrier to care (Disability Rights Commission 2006; Department of Health 2013; Heslop et al. 2013), and recent reports have called for initiatives to improve physical health monitoring (Mencap 2004; Disability Rights Commission 2006; Health Equalities Framework 2013). Quality improvement (QI) has been proposed as a method of improving physical health monitoring (Department of Health 2014a), proffering a rapid and inexpensive way of instigating change