Decision support tool for physical health (DST-PH): stratifying risks to reduce avoidable deaths in people with intellectual disability
| Date | 30 April 2024 |
| Pages | 49-62 |
| DOI | https://doi.org/10.1108/AMHID-07-2023-0025 |
| Published date | 30 April 2024 |
| Author | Sujeet Jaydeokar,Mahesh Odiyoor,Faye Bohen,Trixie Motterhead,Daniel James Acton |
Decision support tool for physical health
(DST-PH): stratifying risks to reduce
avoidable deaths in people with
intellectual disability
Sujeet Jaydeokar, Mahesh Odiyoor, Faye Bohen, Trixie Motterhead and Daniel James Acton
Abstract
Purpose –People with intellectual disability die prematurely and from avoidable causes. Innovative
solutionsand proactive strategies have beenlimited in addressing this disparity.This paper aims to detail
the process of developing a risk stratification tool to identify thoseindividuals who are higher risk of
prematuremortality.
Design/methodology/approach –This study used population health management principles to
conceptualisea risk stratification tool for avoidabledeaths in people with intellectualdisability. A review of
the literature examined the existingevidence of causes of death in people with intellectual disability. A
qualitativemethodology using focused groupsof specialist clinicians was used tounderstand the factors
that contributedtowards avoidable deaths in people with intellectualdisability. Delphi groups were used
for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for
PhysicalHealth).
Findings –A pilot of the Decision Support Toolfor Physical Health within specialist intellectual disability
service demonstrated effective utility and acceptability in clinical practice. The tool has also
demonstrated good faceand construct validity. A further study is currently being completedto examine
concurrentand predictive validity of the tool.
Originality/value –To the best of the authors’ knowledge, this is the only study that has used a
systematic approach to designing a risk stratification tool for identifying premature mortality in people
with intellectualdisability. The Decision Support Tool for PhysicalHealth in clinical practice aims to guide
clinicalresponses and prioritise those identifiedasat higher risk of avoidable deaths.
Keywords Mental health, Health inequalities, Challenging behaviour, STOMP, LeDeR, Mortality review
Paper type Research paper
Background
More people with intellectual disability die prematurely and from preventable causes in
comparison with the general population. Life expectancy for those with intellectual disability
is on average 20years shorter than the general population (Heslop et al.,2014). The risk of
premature mortality is further increased in those with a severe intellectualdisability (Glover
et al.,2017
;Arvio et al.,2017). Itis widely recognised that people with intellectual disability
have a higher level of health needs, including mental health needs, which may place them
at an increased risk of physical health decline (Cooper et al.,2015). Many also need
support to access health-care services due to difficulties such as communication,
challenging behaviours and unstable mental health. Health-care professionals often rely on
their observational skills and those of carers to identify underlying health needs (Heslop
et al.,2014
). Furthermore, people often experience “diagnostic overshadowing” with their
(Informationabout the
authorscan be found at the
end of this article.)
Received 21 July 2023
Revised 25 October 2023
1 November 2023
Accepted 28 November 2023
©Sujeet Jaydeokar, Mahesh
Odiyoor, Faye Bohen, Trixie
Motterhead and Daniel James
Acton. Published by Emerald
Publishing Limited. This article
is published under the Creative
Commons Attribution (CC BY
4.0) licence. Anyone may
reproduce, distribute, translate
and create derivative works of
this article (for both commercial
and non-commercial
purposes), subject to full
attribution to the original
publication and authors. The
full terms of this licence may be
seen at http://creativecom-
mons.org/licences/by/4.0/
legalcode
The authors would like to thank
all the specialist clinicians and
clinical experts who provided
their valuable knowledge and
insight into the development of
the Decision Support Tool for
Physical Health.
Funding: The development of
the Decision Support Tool for
Physical Health was funded by
NHS England and
Improvement.
DOI 10.1108/AMHID-07-2023-0025 VOL. 18 NO. 22024, pp. 49-62, Emerald Publishing Limited, ISSN 2044-1282 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jPAGE 49
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