Health problems of people with intellectual disabilities in general practice: dynamic cohort study between 2012 and 2021 with Dutch routine care data

Background
Despite advancements in health care, patients with intellectual disabilities (ID) in many countries continue to face barriers in accessing and utilising primary care. Implementation of improvements in accessibility and quality of care requires up-to-date and accurate insights into their health problems.

Aim
To investigate health problems in patients with ID in GP care compared with matched patients without ID.

Design and setting
A retrospective dynamic cohort study undertaken using data from >80 Dutch general practices.

Method
All adult patients with indicators of ID, registered at any participating general practice for a minimum of 1 year between 2012 and 2021, were included, and individually matched (1:5) with persons without ID. Patients’ characteristics, encounters, symptoms, diagnoses, and prescribed medication were retrieved.

Results
Patients with ID had 2.2 times more contacts with their GP than patients without ID, presented with a broader range of symptoms and diagnoses across various body systems, and were more frequently prescribed medication. The largest relative difference was seen for depression, which was nearly twice as common in patients with ID compared with those without.

Conclusion
The health problems and prescription patterns of people with ID in general practice remain distinct from those without ID but largely mirror findings from two decades ago. These patterns still fit well within the scope of general practice, yet underscore the continuing need for GPs to recognise these differences and adapt their care to address the specific needs of their patients with ID.