One of the components of policy to improve the health of people with learning disabilities is the recommendation that people should receive annual health checks. Following the introduction of a Direct Enhanced Service in England in 2008 to deliver annual health checks, progress has been made in increasing access to checks across primary care trusts and strategic health authorities . The authors point out though that despite this policy framework, in 2009/2010 only 41% of people who were eligible for a health check received one.
The authors of this review therefore set out to investigate whether there was evidence that annual health checks were having any impact on the health status of people with learning disabilities.
They searched databases from 1989 to 2010 and contacted the International Association for the Scientific Study of Intellectual Disabilities Health Special Interest Research Group to identify papers not found in the electronic searches. 38 publications were eventually identified for inclusion in the review
Three studies were randomised controlled trials, one had a non-randomised matched control group and the majority were based on clinical interventions where a sample of people had a health check and information was presented on the outcomes
The studies involved over 5000 people with learning disabilities from a range of countries. The most frequent outcome measure was whether the checks found previously unidentified health needs. The studies showed that the provision of checks consistently found unmet health needs and enabled targeted action to address these needs.
Despite reporting such actions, very few studies evaluated the extent to which health checks led to health benefits in the short or long term. Studies did report health benefits resulting from health checks in a range of areas and one non-randomised matched control group study with sample of 100 found that significantly more health needs were met for the intervention group than for the control group at follow up after one year.
The authors state that the evidence from the review suggests that health checks were effective in identifying unidentified conditions; that they led to targeted actions to address health needs but that future research needs to evaluate the effectiveness and efficiency of such checks, as the current evidence base mainly consists of small-scale studies.
They conclude that health checks are effective in identifying previously unrecognised health needs, including life-threatening conditions.
The impact of health checks for people with intellectual disabilities: a systematic review of evidence, Robertson J et al., in Journal of Intellectual Disability Research, 55: 1009–1019