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Diabetes care in Ireland: a survey of general practitioners.

Abstract：

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.

journal_name

Prim Care Diabetes

journal_title

Primary care diabetes

authors

Mc Hugh S,O'Keeffe J,Fitzpatrick A,de Siún A,O'Mullane M,Perry I,Bradley C,National Diabetes Register Project (NDRP).

doi

10.1016/j.pcd.2009.09.002

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

225-31

issue

eissn

1751-9918

issn

1878-0210

pii

S1751-9918(09)00090-4

journal_volume

pub_type

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Diabetes care in Ireland: a survey of general practitioners.