Enhancing the dietary management of general practice patients through collaborative care: perspectives of general practitioners and dietitians
Aim: To describe how general practitioners and dietitians view their role in the dietary management of cardiac patients and to provide insights on how to facilitate collaborative care.ndi_1333 81..86Methods: Two studies were conducted in Victoria (Australia) 2005ÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ2006. Study One: semi-structured interviews with general practitioners. Study Two: cross-sectional quantitative surveys of general practitioners and dietitians.Study One: texts were analysed using the grounded theory approach. Study Two: frequency analysis was conducted and chi-squared test for independence was used to explore the impact of age, sex and consultation time on the role and reporting scales.Results: Study One: Themes arising from the interviews with 30 general practitioners showed their involvement in dietary management fell into three broad roles: ÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂInfluencingÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ, ÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂCoordinatorÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ of referrals and dietary ÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂEducatorÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ. They described dietetic education as a process that included dietary assessment, education, application of behavioural change techniques and reporting back to general practitioners. Study Two: Respondents were 248 general practitioners (30% response) and 180 dietitians (60% response). General practitionersÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ counselling consisted mostly of advocating for dietary change, coordinating dietetic referrals and reinforcing dietitiansÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ recommendations. General practitioners considered dietary education as the role of dietitians. Dietitians reported a much broader role in themanagement of patients with some overlap with general practitionersÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ roles.Conclusions: The findings indicate the need: (i) for more structured reporting to ensure general practitioners receive appropriate information to enable them to reinforce dietetic counselling and recommendations; and (ii) to streamline the communication process in order to expedite dietitiansÃÂÃÂÃÂÃÂ¢ÃÂÃÂÃÂÃÂÃÂÃÂÃÂÃÂ reports to general practitioners.