Primary Care of Adults with Intellectual and Developmental Disabilities.

Most adults with intellectual and developmental disabilities receive care through primary care providers in their communities. An interdisciplinary approach that incorporates home- and community-based services is effective and can be facilitated by care managers in a medical home model. Preventive services should follow established guidelines as in the general population with some modifications, including regular monitoring of weight and height. Swallowing difficulties and gastroesophageal reflux disease are not uncommon and increase the risk for respiratory disorders. A medication review should be conducted at regular intervals to check for polypharmacy, and antipsychotic drugs should no longer be used routinely to treat problem behaviors. Pain and other physical symptoms often are unrecognized and can present atypically in acute situations.