‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register
Objective The aim of this study was to investigate the attitudes of general practitioners (GPs) to the development of a national diabetes register as a way of improving the quality of care. Design Qualitative study using semistructured interviews. Setting General practice, Ireland. Participants Purp...
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description | Objective The aim of this study was to investigate the attitudes of general practitioners (GPs) to the development of a national diabetes register as a way of improving the quality of care. Design Qualitative study using semistructured interviews. Setting General practice, Ireland. Participants Purposive sample of 29 GPs and two practice nurses. Participants’ practices varied by (a) location (rural/urban), (b) size (single-handed/group practice) and (c) extent of computerisation. Methods The semistructured topic guide focused on experiences of change in the health system at a local and national level and attitudes towards the development of a national diabetes register. Analysis was conducted using the Framework approach. Results Participants were sceptical about the development of a national diabetes register. The main advantage was ‘knowing the numbers’ for epidemiological and policy purposes. However, participants questioned the benefits for their practice and patients. There were concerns that it would drain resources from other priorities and distract from patient management. These attitudes were strongly influenced by previous experience of change in the health system. Participants felt that remuneration would be necessary to ensure full engagement, reflecting wider frustrations with payment structures for general practice. There was a sense of wariness towards health service administration which was not specific to diabetes care but which coloured some participants’ attitudes towards a national register. In contrast, participants referred to positive experiences of change at a local level, facilitated by a ‘practice ethos’ and professional leadership. Conclusions This study highlights the growing sense of scepticism and inertia towards change within the health system. This inertia stems from previous experience and the competing demands of maintaining versus improving care in a system with dwindling resources. |
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Design Qualitative study using semistructured interviews. Setting General practice, Ireland. Participants Purposive sample of 29 GPs and two practice nurses. Participants’ practices varied by (a) location (rural/urban), (b) size (single-handed/group practice) and (c) extent of computerisation. Methods The semistructured topic guide focused on experiences of change in the health system at a local and national level and attitudes towards the development of a national diabetes register. Analysis was conducted using the Framework approach. Results Participants were sceptical about the development of a national diabetes register. The main advantage was ‘knowing the numbers’ for epidemiological and policy purposes. However, participants questioned the benefits for their practice and patients. There were concerns that it would drain resources from other priorities and distract from patient management. These attitudes were strongly influenced by previous experience of change in the health system. Participants felt that remuneration would be necessary to ensure full engagement, reflecting wider frustrations with payment structures for general practice. There was a sense of wariness towards health service administration which was not specific to diabetes care but which coloured some participants’ attitudes towards a national register. In contrast, participants referred to positive experiences of change at a local level, facilitated by a ‘practice ethos’ and professional leadership. Conclusions This study highlights the growing sense of scepticism and inertia towards change within the health system. This inertia stems from previous experience and the competing demands of maintaining versus improving care in a system with dwindling resources.</description><identifier>ISSN: 2044-5415</identifier><identifier>EISSN: 2044-5423</identifier><identifier>DOI: 10.1136/bmjqs-2013-002626</identifier><identifier>PMID: 25038038</identifier><language>eng</language><publisher>London: BMJ Group</publisher><subject>Adult ; Attitude of Health Personnel ; Biological and medical sciences ; Diabetes Mellitus - therapy ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; General populations ; General Practitioners - psychology ; Health administration ; Health services ; Humans ; Interviews as Topic ; Ireland ; Male ; Medical sciences ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative Research ; Quality Improvement ; Registries</subject><ispartof>BMJ quality & safety, 2014-11, Vol.23 (11), p.910-917</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2015 INIST-CNRS</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b429t-36023729b6366b5d5ae0e00884232c23b3fef8a60682d032dd5d702939e83b8d3</citedby><cites>FETCH-LOGICAL-b429t-36023729b6366b5d5ae0e00884232c23b3fef8a60682d032dd5d702939e83b8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://qualitysafety.bmj.com/content/23/11/910.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://qualitysafety.bmj.com/content/23/11/910.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28881048$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25038038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mc Hugh, Sheena M</creatorcontrib><creatorcontrib>O'Mullane, Monica</creatorcontrib><creatorcontrib>Perry, Ivan J</creatorcontrib><creatorcontrib>Bradley, Colin</creatorcontrib><creatorcontrib>National Diabetes Register Project (NDRP)</creatorcontrib><title>‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register</title><title>BMJ quality & safety</title><addtitle>BMJ Qual Saf</addtitle><description>Objective The aim of this study was to investigate the attitudes of general practitioners (GPs) to the development of a national diabetes register as a way of improving the quality of care. Design Qualitative study using semistructured interviews. Setting General practice, Ireland. Participants Purposive sample of 29 GPs and two practice nurses. Participants’ practices varied by (a) location (rural/urban), (b) size (single-handed/group practice) and (c) extent of computerisation. Methods The semistructured topic guide focused on experiences of change in the health system at a local and national level and attitudes towards the development of a national diabetes register. Analysis was conducted using the Framework approach. Results Participants were sceptical about the development of a national diabetes register. The main advantage was ‘knowing the numbers’ for epidemiological and policy purposes. However, participants questioned the benefits for their practice and patients. There were concerns that it would drain resources from other priorities and distract from patient management. These attitudes were strongly influenced by previous experience of change in the health system. Participants felt that remuneration would be necessary to ensure full engagement, reflecting wider frustrations with payment structures for general practice. There was a sense of wariness towards health service administration which was not specific to diabetes care but which coloured some participants’ attitudes towards a national register. In contrast, participants referred to positive experiences of change at a local level, facilitated by a ‘practice ethos’ and professional leadership. Conclusions This study highlights the growing sense of scepticism and inertia towards change within the health system. This inertia stems from previous experience and the competing demands of maintaining versus improving care in a system with dwindling resources.</description><subject>Adult</subject><subject>Attitude of Health Personnel</subject><subject>Biological and medical sciences</subject><subject>Diabetes Mellitus - therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>General populations</subject><subject>General Practitioners - psychology</subject><subject>Health administration</subject><subject>Health services</subject><subject>Humans</subject><subject>Interviews as Topic</subject><subject>Ireland</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. 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Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>General populations</topic><topic>General Practitioners - psychology</topic><topic>Health administration</topic><topic>Health services</topic><topic>Humans</topic><topic>Interviews as Topic</topic><topic>Ireland</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Qualitative Research</topic><topic>Quality Improvement</topic><topic>Registries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mc Hugh, Sheena M</creatorcontrib><creatorcontrib>O'Mullane, Monica</creatorcontrib><creatorcontrib>Perry, Ivan J</creatorcontrib><creatorcontrib>Bradley, Colin</creatorcontrib><creatorcontrib>National Diabetes Register Project (NDRP)</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>BMJ quality & safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mc Hugh, Sheena M</au><au>O'Mullane, Monica</au><au>Perry, Ivan J</au><au>Bradley, Colin</au><aucorp>National Diabetes Register Project (NDRP)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register</atitle><jtitle>BMJ quality & safety</jtitle><addtitle>BMJ Qual Saf</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>23</volume><issue>11</issue><spage>910</spage><epage>917</epage><pages>910-917</pages><issn>2044-5415</issn><eissn>2044-5423</eissn><abstract>Objective The aim of this study was to investigate the attitudes of general practitioners (GPs) to the development of a national diabetes register as a way of improving the quality of care. Design Qualitative study using semistructured interviews. Setting General practice, Ireland. Participants Purposive sample of 29 GPs and two practice nurses. Participants’ practices varied by (a) location (rural/urban), (b) size (single-handed/group practice) and (c) extent of computerisation. Methods The semistructured topic guide focused on experiences of change in the health system at a local and national level and attitudes towards the development of a national diabetes register. Analysis was conducted using the Framework approach. Results Participants were sceptical about the development of a national diabetes register. The main advantage was ‘knowing the numbers’ for epidemiological and policy purposes. However, participants questioned the benefits for their practice and patients. There were concerns that it would drain resources from other priorities and distract from patient management. These attitudes were strongly influenced by previous experience of change in the health system. Participants felt that remuneration would be necessary to ensure full engagement, reflecting wider frustrations with payment structures for general practice. There was a sense of wariness towards health service administration which was not specific to diabetes care but which coloured some participants’ attitudes towards a national register. In contrast, participants referred to positive experiences of change at a local level, facilitated by a ‘practice ethos’ and professional leadership. Conclusions This study highlights the growing sense of scepticism and inertia towards change within the health system. This inertia stems from previous experience and the competing demands of maintaining versus improving care in a system with dwindling resources.</abstract><cop>London</cop><pub>BMJ Group</pub><pmid>25038038</pmid><doi>10.1136/bmjqs-2013-002626</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Attitude of Health Personnel Biological and medical sciences Diabetes Mellitus - therapy Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female General populations General Practitioners - psychology Health administration Health services Humans Interviews as Topic Ireland Male Medical sciences Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative Research Quality Improvement Registries |
title | ‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register |
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