Managing chronic conditions in Irish primary care question verification form

  • Published: 8 May 2024
  • Version: V2
  • 4 min read

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

Managing chronic conditions in Irish primary care

Please describe the scope of the PSP

The aim of the ‘Managing Chronic Conditions in Irish Primary Care PSP’ is to identify the unanswered questions about the management of chronic illnesses in primary care from patient, carer and clinical perspectives and then prioritise those that people with chronic conditions, their carers and clinicians agree are the most important for research to address.

The objectives of the PSP are to:

  • work with people with chronic conditions, their carers/ family members and healthcare professionals to identify uncertainties about the management of chronic illnesses in primary care settings
  • to agree by consensus a prioritised list of those uncertainties, for research
  • to publicise the results of the PSP and process
  • to engage with funders and other research support bodies to encourage research in the priority areas

The scope of the Managing Chronic Conditions in Irish Primary Care PSP is defined as:

  • Questions about the role of primary care in managing an ongoing chronic condition or supporting the self-management of such conditions or symptoms

    • Chronic condition: any condition or symptom that has long-term effects on a person, needs ongoing management, and which may impact the activities of daily life.
    • Management: the ongoing treatment, coordination, monitoring and support undertaken by people with chronic conditions and healthcare professionals to improve health outcomes.
    • Primary care: treatment and support that is available in the community and involves a sustained relationship or degree of continuity between people with chronic conditions and healthcare professionals. This includes “first contact” practitioners such as general practitioners (GPs), general practice nurses, community and public health nurses, and other community based professionals (eg physiotherapists, occupational therapists etc.)
  • Focused on Ireland (ROI)
  • Concerning adults (18+)

The PSP will exclude from its scope:

  • Services outside of Ireland
  • Under 18 years
  • Focus on specific conditions and/or treatments (e.g. “which is the best drug to treat X” will be out of scope)
  • Conditions that are cared for or treatments that are mostly provided in secondary or tertiary care (i.e. specialist care by consultants or other specialised health professionals, hospital based care).

Please provide a brief overview of your approach to checking whether the questions were unanswered

Our search focused on finding evidence syntheses (systematic reviews and meta analyses) and/or clinical guidelines with relevance to individual questions.

Questions were determined to be unanswered when no systematic review or clinical guidelines could be found, or where relevant syntheses determined that there was insufficient or low quality evidence in the area.

Please list the type(s) of evidence you used to verify your questions as unanswered

  • Evidence syntheses – systematic reviews, meta-analyses
  • Clinical guidelines
  • (in the case of provision of care/policy questions only) HSE and/or Department of Health reports

Please list the sources that you searched in order to identify that evidence

Main sources

  • The Cochrane Library
  • Gov.ie repository of clinical guidelines

Other sources

  • PubMed
  • Google Scholar
  • ICGP clinical guidelines (access restricted to GPs) and guidelines of other professional organisations where appropriate

What search terms did you use?

The following terms were used in combination to best represent the question being investigated (formatted as appropriate for each source’s searching interface to allow for close matches and synonyms):

Review; meta-analysis; synthesis
Primary care; general practice; community care; primary healthcare; GP
Chronic; chronic condition; chronic disease; lifelong
Managing; treating; self-management; monitoring;

Topic specific search terms combined with the above included:
referral; outpatients; hospital; consultant; specialist; access; utilization; cost; burden; education; training; CPD; pain; fatigue; medically unexplained symptoms; waiting list; delay; medication; polypharmacy; data management; patient information; disease management programmes; resourcing; planning; mental health; continuity;

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

  • Searches were limited to title/abstract/keywords rather than fulltext
  • Searches included publications between January 2010 and October 2023
  • English only articles

Results that focused on healthcare systems radically different from the Irish system, or that focused on aspects of health systems that were not comparable to the Irish context were not possible to systematically screen out, and as such were identified while reviewing returned results and discounted on a case-by-case basis.

Names of individuals who undertook the evidence checking

  • Laura O’Connor
  • Louise O’Grady
  • Razan Alkhabbaz

On what date was the question verification process completed?

August – October 2023

Any other relevant information

None

Version 2 Date 19.12.2023