Diabetes care in Ireland: A survey of general practitioners

Mc Hugh, Sheena; O’Keeffe, Jo; Fitzpatrick, Anne; de Siún, Anna; O’Mullane, Monica; Perry, Ivan; Bradley, Colin; On behalf of the National Diabetes Register Project (NDRP),

doi:10.1016/j.pcd.2009.09.002

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Volume 3, Issue 4 , Pages 225-231, November 2009

Diabetes care in Ireland: A survey of general practitioners

Sheena Mc Hugh
- Department of Epidemiology & Public Health, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Ireland
- Corresponding author. Tel.: +353 21 420 5253; fax: +353 21 420 1923.
Jo O’Keeffe
- Department of General Practice, University College Cork, Ireland
Anne Fitzpatrick
- Department of General Practice, University College Cork, Ireland
Anna de Siún
- Irish College of General Practitioners, 4-5 Lincoln Place, Dublin 2, Ireland
Monica O’Mullane
- Department of General Practice, University College Cork, Ireland
Ivan Perry
- Department of Epidemiology & Public Health, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Ireland
Colin Bradley
- Department of General Practice, University College Cork, Ireland
On behalf of the National Diabetes Register Project (NDRP)

Received 30 April 2009; received in revised form 21 September 2009; accepted 22 September 2009. published online 19 October 2009.

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.

Keywords: Diabetes, Primary care, Republic of Ireland, General practitioners