ArticleBMC health services research2011
Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives.
Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Outcomes of guidelines from health technology assessment organizations in community-based primary care: a systematic mixed studies review.International journal of technology assessment in health care · 2024Pooled it
- Systematic review of the appropriateness of eye care delivery in eye care practice.BMC health services research · 2019Pooled it
- The work of local healthcare innovation: a qualitative study of GP-led integrated diabetes care in primary health care.BMC health services research · 2016Trial
- Development of office-hours use of primary health centers in the early years of the 21International journal of circumpolar health · 2022Observational
- The effect of electronic reminders on the recording of diagnoses in primary care: A quasi-experimental before and after study.SAGE open medicine · 2020Article
- A comparison of the effects of electronic reminders and group bonuses on the recording of diagnoses in primary care: a longitudinal follow-up study.BMC research notes · 2017Article
- A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study.International journal of dentistry · 2017Article
- Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.Implementation science : IS · 2016Article
- Comorbidity, health-related quality of life and self-care in type 2 diabetes: a cross-sectional study in an outpatient population.Irish journal of medical science · 2015Article
- Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland.Irish journal of medical science · 2015Article
- Timing of access to secondary healthcare services and lower extremity amputations in patients with diabetes: a case-control study.BMJ open diabetes research & care · 2015Article
- Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis.Health research policy and systems · 2014Article
- Barriers to, and facilitators in, introducing integrated diabetes care in Ireland: a qualitative study of views in general practice.BMJ open · 2013Article
- Adoption and Initial Implementation of a National Integrated Care Programme for Diabetes: A Realist Evaluation.International journal of integrated careArticle
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care.
methodsData, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009).
resultsThe recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71%) was also comparable to England (77%) and Scotland (90%). Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of < 6.5% (< 48 mmol/mol) compared to 25% in England. Applying the NICE target for blood pressure (≤ 140/80 mmHg), 54% of patients reached this target comparable to 60% in England. Slightly less patients were categorised as obese (> 30 kg/m²) in Ireland (50%, n = 1060) compared to Scotland (54%).
conclusionsThis study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few.
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