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Barriers and facilitators to primary healthcare for people with intellectual disabilities and/or autism : an integrative review

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Doherty, A. J., Atherton, H., Boland, P., Hastings, R. P., Hives, L., Hood, K., James-Jenkinson, L., Leavey, R., Randell, E., Reed, J., Taggart, L., Wilson, N. and Chauhan, U. (2020) Barriers and facilitators to primary healthcare for people with intellectual disabilities and/or autism : an integrative review. BJGP Open, 4 (3). bjgpopen20X101030. doi:10.3399/bjgpopen20X101030 ISSN 2398-3795.

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Official URL: https://doi.org/10.3399/bjgpopen20X101030

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Abstract

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.

Item Type: Journal Article
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Autistic people -- Medical care, Intellectual disability -- Treatment , Primary health care, Autism, Developmentally disabled
Journal or Publication Title: BJGP Open
Publisher: Royal College of General Practitioners
ISSN: 2398-3795
Official Date: August 2020
Dates:
DateEvent
August 2020Published
1 July 2020Available
23 October 2019Accepted
Volume: 4
Number: 3
Article Number: bjgpopen20X101030
DOI: 10.3399/bjgpopen20X101030
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Copyright Holders: Copyright © 2020, The Authors
Date of first compliant deposit: 24 February 2021
Date of first compliant Open Access: 24 February 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
LIFE-IAMPAL0518University of Central Lancashirehttp://dx.doi.org/10.13039/100010044
Applied Research Collaboration North West Coast[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Is Part Of: 1
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