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Background: GPs and mental health nurse practitioners (MHNPs) often feel ill equipped to provide mental health (MH) care to people with mild intellectual disabilities (MID). This is worrying, as insufficient primary MH care may lead to more severe or chronic problems. To improve primary MH care for this patient group, account must be taken of the experiences and needs of GPs and MHNPs providing the care. Aim: To explore GPs' and MHNPs' experiences, needs, and recommendations for improvement regarding primary MH care for adults with MID. Design & setting: A qualitative study was undertaken using focus groups with GPs and MHNPs in the Netherlands. Method: The focus groups were guided by topics based on an interview study with adults with MID receiving primary MH care. Transcripts were analysed by thematic analysis. Results: Four focus groups, with 19 GPs and nine MHNPs, revealed four themes describing the needs and perceived complexity involved in providing MH care to patients with both MID and MH problems: (1) GPs' and MHNPs' struggles with adapting to challenging patient characteristics; (2) importance and difficulties of establishing a good doctor-patient relationship; (3) facilitating and hampering roles of the patient's network; and (4) GPs' and MHNPs' challenges to provide care in the healthcare chain. Conclusion: GPs and MHNPs often experience providing care and support to this patient group as burdensome. It is important to consider the MID throughout the MH trajectory, to invest in a strong doctor-patient relationship, and to establish a stable, sustainable network and coordinated collaborative care around the patient. [ABSTRACT FROM AUTHOR]

Aims: To conduct an epidemiological analysis of patterns observed in diabetes care provided to individuals with and without intellectual disabilities (ID) in primary care settings., Methods: An ID-cohort (N = 21,203) was compared with a control group of similar age and sex from the general Dutch population (N = 267,628). Distinctive data for diabetes (both type 1 and type 2) and related complications were retrieved from national databases., Results: The prevalence of diabetes was higher in people with ID than in the general population (9.9% versus 6.6%). Largest differences were seen in younger age groups. Women with ID had diabetes more often than men with ID. Complications were less common in people with ID than in the general population (IR 58.6 vs. 70.4). In particular, cardiological complications were noted less, while surgical interventions and hospitalization occurred more often., Conclusions: Although diabetes was 1.5 times more prevalent in people with ID than in other people, related complications were less common, followed different patterns and were more severe than in the general population. Future research is needed to understand of the underlying causal mechanisms and to lower the risk of severe diabetic complications among people with ID., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Pulmonary function testing is not feasible in many adults with intellectual disabilities, because of difficulties with understanding and cooperation., Aims: To investigate feasibility, repeatability and reproducibility of measuring airway resistance using the interrupter technique (MicroRint) in people aged 50 years or over with a mild, moderate or severe intellectual disability., Method: Sixty-seven participants were recruited through three Dutch care centres. Feasibility (percentage adequate first measurements) as well as repeatability and reproducibility were evaluated using the Intraclass Correlation Coefficient (ICC) and the within subject variation (SDw)., Results: The group with a severe intellectual disability was too small for valid analyses and was therefore excluded. Feasibility: in 86.6% of the total study group, 88.2% of the participants with a mild and 89.7% of the people with moderate intellectual disability, the first measurement was successful. Repeatability: In the total study group, the group with a mild and the group with a moderate intellectual disability the ICC values were 0.76, 0.84 and 0.71, respectively, SDw values were 0.11kPa/l/s, 0.10kPa/l/s, 0.10kPa/l/s, respectively. Reproducibility: In the total study group, the group with a mild and the group with a moderate intellectual disability the ICC values were 0.72, 0.67 and 0.72, respectively, SDw values were 0.14kPa/l/s, 0.15kPa/l/s, 0.11kPa/l/s, respectively., Conclusion: Feasibility, repeatability and reproducibility of measuring airway resistance using the MicroRint are good and acceptable in people with a mild or moderate intellectual disability aged 50 years or over.