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

Tandan, Meera; Twomey, Bebhinn; Twomey, Liam; Egan, Mairead; Bury, Gerard

doi:10.3390/jpm12071157

Cited by 3 publications

(1 citation statement)

References 17 publications

(19 reference statements)

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“…As part of this strategy, a Chronic Disease Management Programme (CDM) has been implemented since 2020 for people with specific chronic diseases, and who have a medical card or a GP visit card. This has the potential to further increase access to health care access, and improve the management of hypertension at the population level [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing

Browne,

Alamin,

Miri

et al. 2024

Clinical Kidney Journal

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Background Hypertension is highly prevalent in chronic kidney disease (CKD), posing a significant but modifiable risk for adverse clinical outcomes. This study explored the prevalence, awareness, treatment, and control of hypertension in older Irish adults with CKD. Methods Data were analysed from participants in Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) who were aged 50 years and older. CKD was defined as eGFR < 60 ml/min/1.72m2, hypertension defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg and/or self-reported use of antihypertensive medication. Participant awareness and treatment of hypertension was based on self-report and SBP/DBP < 140/90 mmHg. Multivariable logistic regression examined relationships with awareness, treatment, and control of hypertension expressed as adjusted odds ratios. Results Prevalence of hypertension was significantly higher in participants with CKD than without (81.9% vs 59.7%, P < 0.001). Among hypertensive individuals, 70.1% (95% CI: 65.8–74.1) were aware, 83.5% (95% CI 80.0–86.6) were on treatment, yet blood pressure control < 140/90 mmHg and < SBP 120 mmHg was achieved in only 49.3% (CI 44.0–54.7%), and 17.9% (CI 14.4–22.1) respectively. In multivariable analysis, advancing age 1.05 (CI 1.01–1.10), obesity 6.23 (CI 2.51–15.5), diabetes 5.78 (CI 1.55–21.5), cardiovascular disease 9.89 (CI 3.27–29.9) were associated with higher odds of treatment, while cardiovascular disease 2.35 (CI 1.39–3.99) and combination antihypertensive therapy 1.76 (CI 1.03–3.01) was associated with blood pressure control. Conclusion The prevalence of hypertension is substantial in older Irish adults with CKD; however, control is poor. Approximately, one third of participants were unaware of their hypertensive status and approximately one fifth were untreated.

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Section: Discussionmentioning

confidence: 99%

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing

Browne,

Alamin,

Miri

et al. 2024

Clinical Kidney Journal

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Teamwork and its impact on chronic disease clinical outcomes in primary care: a systematic review and meta-analysis

Tandan,

Dunlea,

Cullen

et al. 2024

Public Health

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Exploring the experiences of GPs in establishing and operating the chronic disease management programme in clinical practice in Ireland. A qualitative study

Buckley,

O’ Flynn,

Foley

2024

European Journal of General Practice

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Background The management of chronic diseases, in the context of an ageing population and increasing life expectancy, is one of the major challenges facing the Irish health system. In 2020, a chronic disease management programme [CDM] was introduced in Irish general practice as part of a transformation in health policy to meet the changing needs of the population. Objectives To explore GPs’ experiences and perceptions of the impact of the introduction of CDM on general practice in Ireland. Methods 18 semi-structured interviews were conducted with GPs in clinical practice from across Ireland. GPs were purposefully recruited to capture the differing experiences faced by GPs in large and small practices in both urban and rural settings. Interviews were analysed using reflexive thematic analysis. Results GPs were enthusiastic about aspects of CDM, which they felt provided an improved framework for their approach to the management of chronic diseases. However, they described several challenges to implementation, especially around capacity constraints. CDM could have unintended consequences for aspects of routine GP care. GPs described how practice nurses had taken on a central role in both clinical and administrative aspects of the programme. Conclusions GPs value the framework provided by CDM for their approach to the management of chronic disease. However, challenges around practice capacity and its impact both on the delivery of CDM and aspects of routine care highlight the importance for policy makers to provide continued support to strengthen the general practice infrastructure.

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

Cited by 3 publications

References 17 publications

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing

Teamwork and its impact on chronic disease clinical outcomes in primary care: a systematic review and meta-analysis

Exploring the experiences of GPs in establishing and operating the chronic disease management programme in clinical practice in Ireland. A qualitative study

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