The Journal of Family Practice is a peer-reviewed and indexed journal that provides its 95, family physician readers with timely, practical, and evidence-based information that they can immediately put into practice. Research and applied evidence articles, plus patient-oriented departments like Practice Alert, PURLs, and Clinical Inquiries can be found in print and at jfponline. The Web site, which logs an average of , visitors every month, also offers audiocasts by physician specialists and interactive features like Instant Polls and Photo Rounds Fridayβa weekly diagnostic puzzle.
S ome adults who have an intellectual or other developmental disability IDD require extensive subspecialty care; many, however, depend primarily on their family physician for the bulk of their health care. With that reliance in mind, this article provides 1 an overview of important services that family physicians can provide for their adult patients with IDD and 2 pragmatic clinical suggestions for tailoring that care.
Note: We highlight only some high-impact areas of clinical focus; refer to the Canadian consensus guidelines for a comprehensive approach to optimizing primary care for this population. Laura S, a year-old woman with Down syndrome, is visiting your clinic with her mother to establish care. S has several medical comorbidities, including type 2 diabetes, hyperlipidemia, repaired congenital heart disease, schizoaffective disorder, and hypothyroidism.
She is under the care of multiple specialists, including a cardiologist and an endocrinologist. Her medications include the atypical antipsychotic risperidone, which was prescribed for her through the services of a community mental health center.
S is due for multiple preventive health screenings. She indicates that she feels nervous today talking about these screenings with a new physician. Three core concepts of IDD are impairment , disability , and handicap. According to the World Health Organization 2 :. Health care transition HCT is the planned process of transferring care from a pediatric to an adult-based health care setting, 3 comprising 3 phases:. Two critical components of a smooth HCT include initiating the transition early in adolescence and providing transition-support resources, which are often lacking, even in large, integrated health systems.
