Abstract
A survey was made of the diabetic care given by general practitioners in six family practitioner committee areas. Replies were received from 388 practices, representing 1034 principals (effective response rate 69%), serving over two million patients. Fourteen per cent of practices offered mini-clinic facilities for their diabetic patients, although a much greater proportion professed to give either full or shared care to patients in ordinary surgery time. One quarter of practices kept a diabetes register, but fewer had a system of recall for patients to ensure anticipatory care. The barriers which general practitioners most often perceived in the provision of adequate care for diabetics were: lack of time, absence of a recall system and deficiency in their own clinical skills. Seventy seven of the doctors responding to the initial questionnaire participated in an audit of the level of supervision provided for 378 of their diabetic patients. Better levels of supervision of non-insulin dependent diabetics were shown in those practices where diabetes registers were kept, and where special arrangements were made for caring for diabetes. The levels of care provided by those doctors setting aside specific clinic times were not demonstrably superior to those who did not. The findings suggest that provision of support services, particularly expertise in dietetics, would help to increase general practitioners' confidence and enable more of them to improve their care of diabetic patients.
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- Burrows P. J., Gray P. J., Kinmonth A. L., Payton D. J., Walpole G. A., Walton R. J., Wilson D., Woodbine G. Who cares for the patient with diabetes? Presentation and follow-up in seven Southampton practices. J R Coll Gen Pract. 1987 Feb;37(295):65–69. [PMC free article] [PubMed] [Google Scholar]
- Day J. L., Humphreys H., Alban-Davies H. Problems of comprehensive shared diabetes care. Br Med J (Clin Res Ed) 1987 Jun 20;294(6587):1590–1592. doi: 10.1136/bmj.294.6587.1590. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dornan C., Fowler G., Mann J. I., Markus A., Thorogood M. A community study of diabetes in Oxfordshire. J R Coll Gen Pract. 1983 Mar;33(248):151–155. [PMC free article] [PubMed] [Google Scholar]
- Foulkes A., Kinmonth A. L., Frost S., MacDonald D. Organized personal care--an effective choice for managing diabetes in general practice. J R Coll Gen Pract. 1989 Nov;39(328):444–447. [PMC free article] [PubMed] [Google Scholar]
- Gibbins R. L., Rowlands C. J., Saunders J. A management system for diabetes in general practice. Diabet Med. 1986 Sep-Oct;3(5):477–480. doi: 10.1111/j.1464-5491.1986.tb00797.x. [DOI] [PubMed] [Google Scholar]
- Gibbins R. L., Saunders J. Develop diabetic care in general practice. BMJ. 1988 Jul 16;297(6642):187–189. doi: 10.1136/bmj.297.6642.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hayes T. M., Harries J. Randomised controlled trial of routine hospital clinic care versus routine general practice care for type II diabetics. Br Med J (Clin Res Ed) 1984 Sep 22;289(6447):728–730. doi: 10.1136/bmj.289.6447.728. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martin E. E. Organising a practice. Problem identification, disease management, and audit. Br Med J (Clin Res Ed) 1982 Jul 24;285(6337):265–266. doi: 10.1136/bmj.285.6337.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thorn P. A., Russell R. G. Diabetic clinics today and tomorrow: mini-clinics in general practice. Br Med J. 1973 Jun 2;2(5865):534–536. doi: 10.1136/bmj.2.5865.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yudkin J. S., Boucher B. J., Schopflin K. E., Harris B. T., Claff H. R., Whyte N. J., Taylor B., Mellins D. H., Wootliff A. B., Safir J. G. The quality of diabetic care in a London health district. J Epidemiol Community Health. 1980 Dec;34(4):277–280. doi: 10.1136/jech.34.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]