• William F Sullivan, John Heng, Donna Cameron, Yona Lunsky, Tom Cheetham, Brian Hennen, Elspeth A Bradley, Joseph M Berg, Marika Korossy, Cynthia Forster-Gibson, Maria Gitta, Chrissoula Stavrakaki, Bruce McCreary, and Irene Swift.
• St Michael's Hospital and Surrey Place Centre, Toronto, Ontario, Canada. bill.sullivan@utoronto.ca
• Can Fam Physician. 2006 Nov 1; 52 (11): 141014181410-8.

ObjectiveTo develop practical Canadian guidelines for primary health care providers based on the best available evidence for addressing health issues in adults with developmental disabilities (DD).Quality Of EvidenceAuthors of background papers synthesized information from their own clinical experience, from consultations with other experts, and from relevant professional publications. Based on discussions of these papers at a colloquium of knowledgeable health care providers, a consensus statement was developed. Standard criteria were used to select guidelines for consideration and to rank evidence supporting them. Most evidence was level III.Main MessagePeople with DD have complex health issues, some differing from those of the general population. Adequate primary health care is necessary to identify these issues and to prevent morbidity and premature death. Physical, behavioural, and mental health difficulties should be addressed, and primary health care providers should be particularly attentive to the interactions of biological, psychological, and social factors contributing to health, since these interactions can easily be overlooked in adults with DD. Attention must also be paid to such ethical issues as informed consent and avoidance of harm. Developmental disabilities are not grounds for care providers to withhold or to withdraw medically indicated interventions, and decisions concerning such interventions should be based on patients' best interests.ConclusionImplementing the guidelines proposed here would improve the health of adults with DD and minimize disparities in health and health care.

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