Update on 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 healthcare, patients with intellectual disabilities in many countries continue to face barriers in accessing and utilizing primary care. Implementation of improvements in accessibility and quality of care requires up-to-date and accurate insights in their health problems. Aim To investigate health problems in patients with ID in GP care compared with matched patients without ID. Design and Setting Retrospective dynamic cohort study using data from more than 80 Dutch general practices. Method All adult patients with indicators of ID, registered at any participating general practice for a minimum of one 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 visited their GP almost twice as often than patients without ID, presented with a broader range of symptoms and diagnoses across various body systems, and were more frequently prescribed medication. Largest relative difference was seen for depression, which was nearly twice as common in patients with ID compared to 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 recognize these differences and adapt their care to address the specific needs of their patients with ID.