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. 2022 Jul 17;12(7):1157.
doi: 10.3390/jpm12071157.

National Chronic Disease Management Programmes in Irish General Practice-Preparedness and Challenges

Meera Tandan  1 , Bebhinn Twomey  1 , Liam Twomey  1 , Mairead Egan  1 , Gerard Bury  1
Affiliations

National Chronic Disease Management Programmes in Irish General Practice-Preparedness and Challenges

Meera Tandan et al. J Pers Med. .

Abstract

Information on the readiness of Irish general practice to participate in structured chronic disease management (CDM) care is limited. This study explores the logistic, staffing, and organizational preparedness of Irish general practice to do so, stratified by their size, location, and training status; implementation challenges were also explored. An anonymous, paper-based random survey was performed. A chi-square test was applied to compare practices by location (urban/rural), post-graduate training status (with/without), and numbers of GMS patient (≥1500/>1500 patients) and prevalence ratio and Poisson regression analysis to examine the relationship of staffing with key variables. Overall, 125/243 practices participated, 22% were rural, 56.6% were post-graduate training practices, and 53.9% had ≥1500 GMS patients. The rural, non-training practices and those with <1500 GMS patients had substantially lower staffing levels. The average number of GPs was significantly less in rural practices; however, the difference was insignificant for nurses. Salary costs for practice nurses in all practices and staff IT training and clinical equipment in smaller practices were important barriers. Most practices reported ‘inadequate’ waiting times for access to almost all referral and paramedical services. The study recommends addressing the staffing, funding, and training challenges within Irish general practice to effectively implement a structured CDM program.

Keywords: challenges; chronic disease management; general practice; primary care; resource profiling; rural differences.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Characteristics of practice by location, training, and GMS patients’ size.
Figure 2
Figure 2
Barriers to implementing HSE CDM programme in general practice.
Figure 3
Figure 3
Staff availability and training adequacy to implement different chronic conditions under HSE CDM programme in general practice. COPD = Chronic Obstructive Pulmonary Disease, IHD = Ischemic Heart Disease.
Figure 4
Figure 4
Agreement on the expansion of other health services to HSE CDM programme in general practice.
See this image and copyright information in PMC

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