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J Clin Nurs. 2011 May;20(9-10):1264-72. doi: 10.1111/j.1365-2702.2010.03562.x. Epub 2011 Mar 15.

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

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  • 1Diabetes Centre, Isala Clinics, Langerhans Medical Research Foundation, Zwolle, The Netherlands.

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.

© 2011 Blackwell Publishing Ltd.

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PMID:
21401764
[PubMed - indexed for MEDLINE]
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