The GP perspective: problems experienced in providing diabetes care in UK general practice

Agarwal, Gina; Pierce, Mary; Ridout, Deborah

doi:10.1046/j.1464-5491.19.s4.4.x

Cited by 16 publications

(9 citation statements)

References 35 publications

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“…Shortages and lack of facilities are among the influential issues on the caring process for the diabetic foot ulcer. The findings of Agarwal, et al in 2002 indicated that the main obstacles for providing care to diabetic patients are the shortage of human resources, having insufficient time for training and getting information about new protocols, excessive workload and lack of standardized protocols for treating the diabetic patients [21]. Among the findings of the present study, one of the influential deficiencies is human resources shortage.…”

Section: Discussionmentioning

confidence: 67%

The care process of diabetic foot ulcer patients: a qualitative study in Iran

Aliasgharpour

Nayeri

2012

J Diabetes Metab Disord

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BackgroundThe Purpose of this study is to clarify the care process for Iranian diabetic patients with diabetic foot ulcer condition.MethodsThe main question of this research was “How is the care process for diabetic foot ulcer patients and how do patients experience it?” This study was within the Grounded Theory method. Data collection was carried out until data saturation was achieved. Saturation was achieved after interviewing 11 patients, 4 physicians, one head nurse and one nurse.ResultsThree main themes emerged from this study, including: “disease management, disease experience and continuity of care”. Each of these themes is consisted of different sub-themes.ConclusionsThis is the first study to describe the care process in Iranian diabetic patients with diabetic foot ulcer disease. Knowing patients’ experience and the manner of dealing with them once faced with foot ulcer condition could facilitate a comprehensive decision making by therapists and better recovery of diabetic patients.

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Section: Discussionmentioning

confidence: 67%

The care process of diabetic foot ulcer patients: a qualitative study in Iran

Aliasgharpour

Nayeri

2012

J Diabetes Metab Disord

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“…The results of the general practice survey reported here complement those of Pierce et al . [2,7]. Their survey, although it achieved higher participation, was less detailed than that described here, which achieved only 40% response but with large numbers of practices taking part.…”

Section: Discussionmentioning

confidence: 85%

“…Within this, the vital role of primary care, particularly regarding diabetes diagnosis, appropriate referral and continuing care is recognized. There has been one previous national survey of staffing, facilities and practices related to diabetes in primary care [2]. Diabetes UK (formerly the British Diabetic Association (BDA)) has issued guidance as to how this care should be provided [3].…”

Section: Introductionmentioning

confidence: 99%

Diabetes UK funded surveys of the structural provision of primary care diabetes services in the UK

et al. 2002

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Seventy-nine per cent of the PCOs and 40% of the practices provided usable information. There is evidence that respondents were not significantly biased in relation to their interest in diabetes care. Diabetes was included as a Health Improvement Programme (or equivalent) priority by 62% of PCOs and had been identified as a clinical governance priority by 27%. Sixty-five per cent had information about the ethnic composition of their general population, 57% had an estimate of the number of people with diabetes. Sixty-nine per cent had a local diabetes register but this was said to cover the entire local population in only 64% of these. At least one audit of diabetes care had been carried out (in the previous 5 years) in 75% and, in 76%, clinical guidelines on diabetes care were made available to practices. In the practices, 80% had a designated lead person for diabetes. Seventy-three per cent had at least one general practitioner with a special interest and 87% at least one nurse. Seventy-two per cent of practices ran specific diabetes clinics and 51% had a screening policy. Eighty-six per cent considered that they had adequate systems in place for the delivery of diabetes care. However, only 6% were able to offer a dedicated diabetes telephone help or advice line and only 9% an evening out of hours clinic. Regular practice meetings were held to discuss diabetes in 35%, whereas 39% had a formal shared care protocol. Fourteen per cent held regular joint meetings with the hospital-based team and in 38% there was membership of Diabetes UK for at least one partner or the practice itself. A third (34%) of responding practices were unsure whether a Local Diabetes Services Advisory Group or equivalent existed in their area. Geographical differences in service provision were identified with, for example, practices in London having fewer components in place that were specifically related to the provision of diabetes care. Single-handed practices, wherever they were situated, had in place fewer staff and facilities specifically for diabetes care.

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“…Studies investigating the perspectives of health care professionals who manage diabetes have been performed in other parts of the world including Ethiopia [ 11 ], New Zealand [ 12 ], North America [ 13 – 17 ], Europe [ 18 – 20 ] and Asia [ 21 , 22 ]. These studies demonstrated that HCP report multiple barriers to caring for persons with diabetes such as inadequate funding, limited time to spend with patients, poor access to specialists, ineffective patient and HCP education on diabetes care, and lack of patient motivation to make lifestyle changes.…”

Section: Discussionmentioning

confidence: 99%

Barriers to optimal diabetes care in Trinidad and Tobago: a health care Professionals’ perspective

Roopnarinesingh

Brennan

Khan

et al. 2015

BMC Health Serv Res

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BackgroundThe republic of Trinidad and Tobago (T&T) is a middle income country with a comparatively high prevalence of diabetes mellitus (DM) compared to others in the Caribbean. To date, there have been no studies on health care professionals’ (HCP) perspectives regarding the barriers to achieving optimal care of patients with DM in this country and few previous studies in the Caribbean, yet such perspectives are imperative to develop strategies that reduce the global burden of this disease.MethodsAn electronic invitation was sent to prospective HCP in T&T inviting them to attend a symposium on DM and cardiovascular disease. A total of 198 HCP participants attended of whom approximately 100 participants completed an Audience Response Survey at the completion of the conference. The Audience Response Survey included questions regarding access to resources, need for prevention and education, and coordination of care for to diabetes care in T&T. Responses were analyzed in aggregate.ResultsThe 198 HCP participants attending the symposium included mostly nurses (40 %) and physicians (43 %). The most common specialty indicated by the 198 HCP participants was Internal and Family Medicine (28 %), followed by Anesthesiology (7 %), Emergency Medicine (6 %), Endocrinology and Diabetes (5 %) and Cardiology (3 %). Among the ~100 HCP who completed the Audience Response Survey, multiple barriers to achieving optimal care of patients with diabetes were reported such as: limited access to blood testing (75 %), ophthalmological evaluations (96 %), ECGs (69 %), and cardiac stress tests (92 %); inadequate time to screen and evaluate DM complications (95 %); poor access to consultants for referral of difficult cases (77 %); and lack of provider education regarding cardiovascular complications of DM (57 %). HCP agreed that nurses could potentially be considered to have a more active role in the care and prevention of cardiovascular disease and diabetes through leading patient education efforts (98 %), screening patients for complications (91 %), coordinating care efforts (99 %) and educating family members (98 %).ConclusionsThe HCP in our study reported significant barriers to achieving optimal diabetes care in T&T. In the future, such barriers to care will need to be addressed in order to respond to the projected growth of diabetes in developing countries both within the Caribbean and globally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1066-y) contains supplementary material, which is available to authorized users.

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The GP perspective: problems experienced in providing diabetes care in UK general practice

Cited by 16 publications

References 35 publications

The care process of diabetic foot ulcer patients: a qualitative study in Iran

The care process of diabetic foot ulcer patients: a qualitative study in Iran

Diabetes UK funded surveys of the structural provision of primary care diabetes services in the UK

Barriers to optimal diabetes care in Trinidad and Tobago: a health care Professionals’ perspective

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