Diagnostic overshadowing: a growing concern for patients with LD?
Research type
Research Study
Full title
Diagnostic overshadowing: a growing concern in patients with learning disabilities in Greater Glasgow and Clyde?
IRAS ID
255047
Contact name
Zuzanna Siedlecka
Contact email
Sponsor organisation
University of Aberdeen and NHS Grampian
Duration of Study in the UK
0 years, 1 months, 23 days
Research summary
This project aims to assess whether diagnostic overshadowing may be a growing concern in patients with learning disability.
Diagnostic overshadowing in the context of learning disability describes attributing physical symptoms of an illness to a pre-existing diagnosis of learning disability, rather than considering the physical symptoms as a possible new or separate diagnosis of ill health.
People who have a learning disability often have significantly poorer health (i.e. shorter life expectancy and higher co-morbidity) compared to the rest of the population. Some of these complex health needs remain unmet by healthcare providers.Financial incentive for annual health checks was introduced to combat these health inequalities. NICE guidelines state that annual health checks for all adults with learning disability should encompass a physical health check as well as a mental health review. Health checks are important for learning disabled patients since this population has a greater mortality than controls due to conditions that are to some extent treatable, which go undiagnosed and or not effectively managed. A recent randomised controlled trial concluded that health checks are an effective way of discovering new health conditions in learning disabled patients and meeting their health monitoring needs.
The enhanced service contract expired in 2017 and was not renewed. This could potentially increase the risk of diagnostic overshadowing in patients with learning disabilities. This will be assessed by sending online questionnaires to all general practitioners, as well as community learning disability teams, in the study area- Greater Glasgow & Clyde. Questions will focus on determining whether these professionals consider diagnostic overshadowing to be a significant issue for this group of patients. Questions will also evaluate perceptions of and attitudes towards general health checks of adults with learning disabilities.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
19/WM/0090
Date of REC Opinion
12 Mar 2019
REC opinion
Favourable Opinion