Case management and care expertise as a prevention approach for adults with intellectual disabilities (FaPP‑MgB) - results of a randomised-controlled trial

Background: People with intellectual disabilities (PWID) have a higher risk of several chronic diseases, and face several barriers to accessing health care. They are less likely to receive health promotion and prevention interventions. This study aims to address this issue through the implementation of prevention-focused case management by advanced practice nurses (APNs). Objectives: The goal of this study was to improve the participants’ health status, resilience and health-related quality of life. Methods: We conducted a randomised-controlled trial with waiting list design. Inclusion criteria were ICD diagnosis F70-79 and age ≥18 years. Exclusion criteria were a level of care >3 (according to the German Social Code XI) or being at the end-of-life. Participants lived in inpatient and community settings. The intervention focused on four prevention domains (mobility, nutrition, stress, addiction) and consisted of 1) social space analysis, 2) four outreach visits by eight APNs over one year including assessment of the participant’s health needs, joint development of a prevention plan, case management, evaluation of the plan’s implementation, and 3) individual or group counselling. The control group received usual care. The primary outcome was health status at 12 months (WHODAS 2.0). Secondary outcomes were health status at 6 months, resilience (RS-11) and quality of life (EQ5D-VAS) at 6 and 12 months. We analysed data using ANCOVAs. Results: 214 people were included in the study, 107 in each group. Data are currently being analysed and results will be presented at the conference. Conclusion: The study is expected to improve health outcomes and, as an overarching goal, social participation by reducing barriers to prevention and health promotion for PWID. Significance (Impact and Reach): This is the first study on prevention for PWID using APNs in Germany. Depending on the results, the intervention may become standard service funded by health insurance in the future.