AIM: To investigate the organisation of diabetes care in general practice in Ireland and identify areas for future development. METHODS: Survey of a representative sample of 600 general practitioners (GPs). The questionnaire contained closed and open-ended questions addressing 4 topics; characteristics of the practice, diabetes care delivery, use of services and opportunities for developing diabetes care. RESULTS: The response rate was 44% (n=262). There were an additional 86 responses to a follow-up shortened version of the survey resulting in a 58% response rate for 9 key questions. The majority of respondents were from an urban (43%, n=112) or a mixed area (39%, n=101) and 19% of practices were single-handed (n=66). The reported prevalence in participating practices was 0.7% for Type 1 diabetes and 2.8% for Type 2 diabetes. Forty-five percent of GPs maintained a diabetes register (n=157) while 53% reported using guidelines (n=140). A formal call recall system was reported by 30% (n=78) with a further 20% (n=54) reporting a regular if informal approach to calling patients for review. With regard to the use of diabetes related services 63% reported direct access to a dietician (n=165), 57% direct access to chiropody services (n=149) and 89% had direct access to retinopathy screening (n=234). There was a significant association between maintaining a diabetes register and other aspects of care delivery such as engaging in formal recall (p<0.001), using guidelines (p<0.001) and a declared special interest in diabetes (p=0.001). Of a number of choices 75% of GPs thought that training was the principal opportunity for improving diabetes care. In response to the open-ended questions GPs cited lack of resources, time constraints and workload as barriers to effective care delivery. CONCLUSIONS: Delivery of diabetes care in Ireland remains largely unstructured. Key challenges to improving diabetes care appear to extend to the system and organisational level of care delivery.
AIM: To investigate the organisation of diabetes care in general practice in Ireland and identify areas for future development. METHODS: Survey of a representative sample of 600 general practitioners (GPs). The questionnaire contained closed and open-ended questions addressing 4 topics; characteristics of the practice, diabetes care delivery, use of services and opportunities for developing diabetes care. RESULTS: The response rate was 44% (n=262). There were an additional 86 responses to a follow-up shortened version of the survey resulting in a 58% response rate for 9 key questions. The majority of respondents were from an urban (43%, n=112) or a mixed area (39%, n=101) and 19% of practices were single-handed (n=66). The reported prevalence in participating practices was 0.7% for Type 1 diabetes and 2.8% for Type 2 diabetes. Forty-five percent of GPs maintained a diabetes register (n=157) while 53% reported using guidelines (n=140). A formal call recall system was reported by 30% (n=78) with a further 20% (n=54) reporting a regular if informal approach to calling patients for review. With regard to the use of diabetes related services 63% reported direct access to a dietician (n=165), 57% direct access to chiropody services (n=149) and 89% had direct access to retinopathy screening (n=234). There was a significant association between maintaining a diabetes register and other aspects of care delivery such as engaging in formal recall (p<0.001), using guidelines (p<0.001) and a declared special interest in diabetes (p=0.001). Of a number of choices 75% of GPs thought that training was the principal opportunity for improving diabetes care. In response to the open-ended questions GPs cited lack of resources, time constraints and workload as barriers to effective care delivery. CONCLUSIONS: Delivery of diabetes care in Ireland remains largely unstructured. Key challenges to improving diabetes care appear to extend to the system and organisational level of care delivery.
Authors: Sheena McHugh; Claire Buckley; Katie Murphy; Sue Doherty; Gabrielle O'Keeffe; Joseph Alade; Elizabeth Keane; Mark James; Ciaran Coughlan; John Traynor; Colin P Bradley; Ivan J Perry; Joe Moran; Diarmuid Quinlan Journal: Br J Gen Pract Date: 2013-02 Impact factor: 5.386
Authors: Sheena Mc Hugh; Paul Marsden; Carmel Brennan; Katie Murphy; Celine Croarkin; Joe Moran; Velma Harkins; Ivan J Perry Journal: BMC Health Serv Res Date: 2011-12-28 Impact factor: 2.655
Authors: Julia Lukewich; Renée Corbin; Elizabeth G VanDenKerkhof; Dana S Edge; Tyler Williamson; Joan E Tranmer Journal: J Eval Clin Pract Date: 2014-05-20 Impact factor: 2.431
Authors: Kevin P Balanda; Claire M Buckley; Steve J Barron; Lorraine E Fahy; Jamie M Madden; Janas M Harrington; Ivan J Perry; Patricia M Kearney Journal: PLoS One Date: 2013-10-16 Impact factor: 3.240
Authors: Máire O'Donnell; Anna de Siún; Monica O'Mullane; Diarmuid Smith; Colin Bradley; Francis M Finucane; Sean F Dinneen Journal: BMC Health Serv Res Date: 2013-11-25 Impact factor: 2.655