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Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial

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  • Sebastiaan T Houweling
  • Nanne Kleefstra
  • Kornelis JJ van Hateren
  • Klaas H Groenier
  • Betty Meyboom‐de Jong
  • Henk JG Bilo

Abstract

Aims and objectives. To determine whether the management of type 2 diabetes mellitus in a primary care setting can be safely transferred to practice nurses. Background. Because of the increasing prevalence of type 2 diabetes mellitus and the burden of caring for individual patients, the demand type 2 diabetes mellitus patients place on primary health care resources has become overwhelming. Design. Randomised controlled trial. Methods. The patients in the intervention group were cared for by practice nurses who treated glucose levels, blood pressure and lipid profile according to a specified protocol. The control group received conventional care from a general practitioner. The primary outcome measure was the mean decrease seen in glycated haemoglobin (HbA1c) levels at the end of the follow‐up period (14 months). Results. A total of 230 patients was randomised with 206 completing the study. The between‐group differences with respect to reduction in HbA1c, blood pressure and lipid profile were not significant. Blood pressure decreased significantly in both groups; 7·4/3·2 mm Hg in the intervention group and 5·6/1·0 mm Hg in the control group. In both groups, more patients met the target values goals for lipid profile compared to baseline. In the intervention group, there was some deterioration in the health‐related quality of life and an increase in diabetes‐related symptoms. Patients being treated by a practice nurse were more satisfied with their treatment than those being treated by a general practitioner. Conclusion. Practice nurses achieved results, which were comparable to those achieved by a general practitioner with respect to clinical parameters with better patient satisfaction. Relevance to clinical practice. This study shows that diabetes management in primary care can be safely transferred to practice nurses.

Suggested Citation

  • Sebastiaan T Houweling & Nanne Kleefstra & Kornelis JJ van Hateren & Klaas H Groenier & Betty Meyboom‐de Jong & Henk JG Bilo, 2011. "Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(9‐10), pages 1264-1272, May.
    • Handle: RePEc:wly:jocnur:v:20:y:2011:i:9-10:p:1264-1272
    DOI: 10.1111/j.1365-2702.2010.03562.x
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    1. Francisco José Amo-Setién & Rebeca Abajas-Bustillo & Blanca Torres-Manrique & Roberto Martín-Melón & Carmen Sarabia-Cobo & Jesús Molina-Mula & Carmen Ortego-Mate, 2019. "Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    2. Julie Gilles de la Londe & Anissa Afrite & Julien Mousquès, 2023. "How does the quality of care for type 2 diabetic patients benefit from GPs-nurses’ teamwork? A staggered difference-in-differences design based on a French pilot program," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 433-466, September.
    3. Marta Gorina & Joaquín T. Limonero & María Álvarez, 2019. "Educational diagnosis of self‐management behaviours in patients with diabetes mellitus, hypertension and hypercholesterolaemia based on the PRECEDE model: Qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 1745-1759, May.
    4. Nahara Anani Martínez-González & Ryan Tandjung & Sima Djalali & Flore Huber-Geismann & Stefan Markun & Thomas Rosemann, 2014. "Effects of Physician-Nurse Substitution on Clinical Parameters: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-11, February.
    5. Sheila Hardy & Philippa Hinks & Richard Gray, 2014. "Does training practice nurses to carry out physical health checks for people with severe mental illness increase the level of screening for cardiovascular risk?," International Journal of Social Psychiatry, , vol. 60(3), pages 236-242, May.
    6. Jorge Caro‐Bautista & Shakira Kaknani‐Uttumchandani & Silvia García‐Mayor & Francisca Villa‐Estrada & Juan Carlos Morilla‐Herrera & Álvaro León‐Campos & Alberto José Gómez‐González & José Miguel Moral, 2020. "Impact of self‐care programmes in type 2 diabetes mellitus population in primary health care: Systematic review and meta‐analysis," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(9-10), pages 1457-1476, May.

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