Chronic disease management in patients attending Irish General Practice training practices

Complexity and workload for patients with chronic diseases in General Practice are poorly understood. Government policy envisages moving workload into primary care. Data was obtained from a GP delivered survey (58 GPs/33 practices) of 160 patients with one or more chronic diseases, and by concurrently extracting data from the patients electronic medical record. Care is physician intensive (average number GP visits 9.2 pa), with limited input from Practice Nurses (1.62 visits pa). Care co-ordination is significant, given complex co morbidity, polypharmacy (average number of medications per patient = 6.8), and numbers of OPDs attended (3.8). Over a quarter of patients (51/160 (27%)) required assistance attending their GP; 60 (31%) self rated their health as fair/poor. Patients are positively disposed towards transfer of care to General Practice. This study provides baseline data on complexity/workload in care delivered in GP Training practices, before implementation of change.