title: Diabetes care provision in UK primary care practices.
abstract: BACKGROUND
  Although most people with Type 2 diabetes receive their diabetes care in primary care, only a limited amount is known about the quality of diabetes care in this setting. We investigated the provision and receipt of diabetes care delivered in UK primary care.
  
  
  METHODS
  Postal surveys with all healthcare professionals and a random sample of 100 patients with Type 2 diabetes from 99 UK primary care practices.
  
  
  RESULTS
  326/361 (90.3%) doctors, 163/186 (87.6%) nurses and 3591 patients (41.8%) returned a questionnaire. Clinicians reported giving advice about lifestyle behaviours (e.g. 88% would routinely advise about calorie restriction; 99.6% about increasing exercise) more often than patients reported having received it (43% and 42%) and correlations between clinician and patient report were low. Patients' reported levels of confidence about managing their diabetes were moderately high; a median (range) of 21% (3% to 39%) of patients reporting being not confident about various areas of diabetes self-management.
  
  
  CONCLUSIONS
  Primary care practices have organisational structures in place and are, as judged by routine quality indicators, delivering high quality care. There remain evidence-practice gaps in the care provided and in the self confidence that patients have for key aspects of self management and further research is needed to address these issues. Future research should use robust designs and appropriately designed studies to investigate how best to improve this situation.
authors.affiliation: The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. gillian.hawthorne@newcastle-pct.nhs.uk
authors.forename: Gillian
authors.initials: G
authors.lastname: Hawthorne
authors.forename: Susan
authors.initials: S
authors.lastname: Hrisos
authors.forename: Elaine
authors.initials: E
authors.lastname: Stamp
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Francis
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Grimshaw
authors.forename: Margaret
authors.initials: M
authors.lastname: Hunter
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
authors.forename: Justin
authors.initials: J
authors.lastname: Presseau
authors.forename: Nick
authors.initials: N
authors.lastname: Steen
authors.forename: Martin P
authors.initials: MP
authors.lastname: Eccles
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D010353:Patient Education as Topic; D063046:Patient Medication Knowledge; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D012648:Self Care; D011795:Surveys and Questionnaires; D006113:United Kingdom