Nurses expand outpatient care for chronically ill adults

July 17, 2014
Nurses expand outpatient care for chronically ill adults

(HealthDay)—Team care involving nurse-managed protocols is one model that may improve outpatient care for adults with chronic conditions, according to research published in the July 15 issue of the Annals of Internal Medicine.

Ryan J. Shaw, Ph.D., R.N., of the Durham Veterans Affairs Medical Center in North Carolina, and colleagues conducted a systematic review of the literature and a meta-analysis of data from 18 studies. The authors sought to assess the effects of nurse-managed protocols on the outpatient management of adults with diabetes, , and hyperlipidemia. All of the studies involved a , or equivalent, who titrated medications according to a protocol.

The researchers found that outpatients with diabetes receiving care under nurse-managed protocols experienced a 0.4 percent decrease in hemoglobin A1c level (eight patients; 95 percent confidence interval [CI], 0.1 to 0.7 percent). Those with hypertension (12 patients) experienced decreases in systolic and of 3.68 mm Hg (95 percent CI, 1.05 to 6.31 mm Hg) and 1.56 mm Hg (95 percent CI, 0.36 to 2.76 mm Hg), respectively. Individuals with had changes in lipid levels, including a 9.37-mg/dL decrease in total cholesterol level (nine patients; 95 percent CI, 20.77-mg/dL decrease to 2.02-mg/dL increase) and a 12.07-mg/dL decrease in low-density lipoprotein cholesterol level (six patients; 95 percent CI, 28.27-mg/dL decrease to 4.13-mg/dL increase).

"We need new models of primary care, and enlisting nurses will be central to this effort," write the authors of an accompanying editorial. "Recognizing that nurse-managed protocols work for common outpatient diseases may be one step toward solving America's primary care problem."

Explore further: Cinnamon cuts blood glucose levels in diabetes patients

More information: Full Text
Editorial (subscription or payment may be required)

Related Stories

Cinnamon cuts blood glucose levels in diabetes patients

September 16, 2013

(HealthDay)—Consumption of cinnamon is associated with favorable reductions in plasma glucose and lipid levels, according to research published in the September/October issue of the Annals of Family Medicine.

Racial disparities persist in diabetes care outcomes

December 2, 2013

(HealthDay)—Black patients do not receive the same quality of care, and experience poorer intermediate outcomes in the practice setting of a patient-centered medical home (PCMH), according to research published online Nov. ...

Interarm BP difference may up cardiac risk in diabetes

April 3, 2014

(HealthDay)—Interarm differences in systolic blood pressure (BP) in patients with diabetes may be associated with an increased risk of cardiovascular morbidity and mortality, according to research published online on March ...

Many at high cardiovascular risk still not on statins

May 13, 2014

(HealthDay)—Many individuals at high risk for cardiovascular events, such as those with coronary artery disease, diabetes, or both, are not receiving statins, according to research published in the May/June issue of the ...

Recommended for you

Older people getting smarter, but not fitter

August 31, 2015

Older populations are scoring better on cognitive tests than people of the same age did in the past —a trend that could be linked to higher education rates and increased use of technology in our daily lives, say IIASA population ...

Higher intelligence score means better physical performance

August 14, 2015

New research reveals a distinct association between male intelligence in early adulthood and their subsequent midlife physical performance. The higher intelligence score, the better physical performance, the study reveals. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.