RT Journal Article
SR Electronic
T1 Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101030
DO 10.3399/bjgpopen20X101030
VO 4
IS 3
A1 Alison Jayne Doherty
A1 Helen Atherton
A1 Paul Boland
A1 Richard Hastings
A1 Lucy Hives
A1 Kerry Hood
A1 Lynn James-Jenkinson
A1 Ralph Leavey
A1 Elizabeth Randell
A1 Janet Reed
A1 Laurence Taggart
A1 Neil Wilson
A1 Umesh Chauhan
YR 2020
UL http://bjgpopen.org/content/4/3/bjgpopen20X101030.abstract
AB Background Globally, people with intellectual disabilities and/or autism experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower than the general population, their health needs are often unmet, and their views and experiences are frequently overlooked in research, policy, and practice.Aim To investigate the barriers and facilitators reported by individuals with intellectual disabilities, autism, or both, and/or their carers, to accessing and utilising primary health care for their physical and mental health needs.Design & setting An integrative review was undertaken, which used systematic review methodology.Method Electronic databases MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane were searched for relevant studies (all languages) using a search strategy. Two researchers independently screened the results and assessed the quality of the studies.Results Sixty-three international studies were identified. Six main themes relating to barriers and facilitators emerged from an analysis of these studies. The main themes were: training; knowledge and awareness; communication; fear and embarrassment; involvement in healthcare decision-making; and time. All the themes were underpinned by the need for greater care, dignity, respect, collaborative relationships, and reasonable adjustments. Opposing barriers and facilitators were identified within each of the main themes.Conclusion Adolescents and adults with intellectual disabilities and/or autism experience several barriers to accessing and utilising primary health care. The findings highlight the reasonable adjustments and facilitators that can be implemented to ensure that these individuals are not excluded from primary health care.