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Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK

Tash Kennedy Kennedy, Jonathan Kennedy, Mike Kerr, Sam Dredge, Sinead Brophy Orcid Logo

BMJ Open, Volume: 12, Issue: 4, Start page: e049441

Swansea University Authors: Tash Kennedy Kennedy, Jonathan Kennedy, Sam Dredge, Sinead Brophy Orcid Logo

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DOI (Published version): 10.1136/bmjopen-2021-049441

Abstract

Objective: To examine if mortality rates are lower in people with intellectual disability who have had a health check compared with those who have not had health checks.Setting: General practice records of 26 954 people with an intellectual disability in Wales between 2005–2017, of which 7650 (28.4%...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2022
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Patients with a health check were matched for age at time of health check with two people who did not have a health check. The health check was associated with improved survival for those with autism or Down&#x2019;s Syndrome (HR 0.58 (95% CI 0.37 to 0.91) and HR 0.76 (95% CI 0.64 to 0.91), respectively). There was no evidence of improved survival for those diagnosed with diabetes or cancer. 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Re-use permitted under CC BY. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-09-02T10:43:59.6074811 v2 60463 2022-07-12 Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK 3f6f07de33204db4c0ab665fb4b36367 Tash Kennedy Kennedy Tash Kennedy Kennedy true false 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false 8652b1ee0e3cf6eb4e6359c0aa2546af Sam Dredge Sam Dredge true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2022-07-12 HDAT Objective: To examine if mortality rates are lower in people with intellectual disability who have had a health check compared with those who have not had health checks.Setting: General practice records of 26 954 people with an intellectual disability in Wales between 2005–2017, of which 7650 (28.4%) with a health check were matched 1:2 with those without a health check.Primary outcome measure: Office of National Statistics mortality data; a Cox regression was utilised to examine time to death adjusted for comorbidities and gender.Results: Patients who had a health check were stratified by those who (1) had a confirmed health check, that is, Read Code for a health check (n=7650 (28.4 %)) and (2) had no evidence of receiving a health check in their medical record. Patients with a health check were matched for age at time of health check with two people who did not have a health check. The health check was associated with improved survival for those with autism or Down’s Syndrome (HR 0.58 (95% CI 0.37 to 0.91) and HR 0.76 (95% CI 0.64 to 0.91), respectively). There was no evidence of improved survival for those diagnosed with diabetes or cancer. The people who had a health check were more likely to be older, have epilepsy and less likely to have autism or Down’s syndrome.Conclusions: Health checks are likely to influence survival if started before a person is diagnosed with a chronic condition, especially for people with autism or Down’s syndrome. Journal Article BMJ Open 12 4 e049441 BMJ 2044-6055 2044-6055 13 4 2022 2022-04-13 10.1136/bmjopen-2021-049441 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) Llywodraeth Cymru - N/A: Infrastructure support without research award; Medical Research Council - NIWA1 2022-09-02T10:43:59.6074811 2022-07-12T16:34:21.8412834 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Tash Kennedy Kennedy 1 Jonathan Kennedy 2 Mike Kerr 3 Sam Dredge 4 Sinead Brophy 0000-0001-7417-2858 5 60463__24559__e5705241e2e24ab3a61b0ea6e5c3498b.pdf 60463.VOR plus supplementary.pdf 2022-07-12T16:40:50.4925532 Output 1302856 application/pdf Version of Record true © Author(s) 2022. Re-use permitted under CC BY. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. true eng https://creativecommons.org/licenses/by/4.0/
title Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
spellingShingle Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
Tash Kennedy Kennedy
Jonathan Kennedy
Sam Dredge
Sinead Brophy
title_short Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
title_full Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
title_fullStr Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
title_full_unstemmed Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
title_sort Health checks for adults with intellectual disability and association with survival rates: a linked electronic records matched cohort study in Wales, UK
author_id_str_mv 3f6f07de33204db4c0ab665fb4b36367
08163d1f58d7fefcb1c695bcc2e0ef68
8652b1ee0e3cf6eb4e6359c0aa2546af
84f5661b35a729f55047f9e793d8798b
author_id_fullname_str_mv 3f6f07de33204db4c0ab665fb4b36367_***_Tash Kennedy Kennedy
08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy
8652b1ee0e3cf6eb4e6359c0aa2546af_***_Sam Dredge
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
author Tash Kennedy Kennedy
Jonathan Kennedy
Sam Dredge
Sinead Brophy
author2 Tash Kennedy Kennedy
Jonathan Kennedy
Mike Kerr
Sam Dredge
Sinead Brophy
format Journal article
container_title BMJ Open
container_volume 12
container_issue 4
container_start_page e049441
publishDate 2022
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2021-049441
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description Objective: To examine if mortality rates are lower in people with intellectual disability who have had a health check compared with those who have not had health checks.Setting: General practice records of 26 954 people with an intellectual disability in Wales between 2005–2017, of which 7650 (28.4%) with a health check were matched 1:2 with those without a health check.Primary outcome measure: Office of National Statistics mortality data; a Cox regression was utilised to examine time to death adjusted for comorbidities and gender.Results: Patients who had a health check were stratified by those who (1) had a confirmed health check, that is, Read Code for a health check (n=7650 (28.4 %)) and (2) had no evidence of receiving a health check in their medical record. Patients with a health check were matched for age at time of health check with two people who did not have a health check. The health check was associated with improved survival for those with autism or Down’s Syndrome (HR 0.58 (95% CI 0.37 to 0.91) and HR 0.76 (95% CI 0.64 to 0.91), respectively). There was no evidence of improved survival for those diagnosed with diabetes or cancer. The people who had a health check were more likely to be older, have epilepsy and less likely to have autism or Down’s syndrome.Conclusions: Health checks are likely to influence survival if started before a person is diagnosed with a chronic condition, especially for people with autism or Down’s syndrome.
published_date 2022-04-13T04:18:35Z
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