RN intervention more successful in chronic cases than physician treatment alone
Chronic disease accounts for 75% of healthcare spending and the shortage of primary care physicians has been identified as the No. 1 barrier to successful management of chronic disease cases. But a new study provides further evidence that specially trained nursing staff can help lighten the load on primary care.
The study, published in the Annals of Internal Medicine, found that chronic patients under a nurse’s care had better blood sugar management, blood pressure readings, and cholesterol levels that patients under a physician’s care alone. No adverse outcomes were reported, according to the study,
“Robust evidence supports the effectiveness of nurses in providing patient education about chronic disease and secondary prevention strategies,” writes lead study author Ryan J. Shaw, Ph.D., RN. “With clearly defined protocols and training, nurses may also be able to order relevant diagnostic tests, adjust routine medications, and appropriately refer patients.”
The nurses in the study group went through specialty training to care for chronic patients, and were able to change dosages of medications originally prescribed by physicians. Nurses in select study groups were also able to initiate new medications on their own, according to the report.
The study piggybacks on the implementation of new healthcare models like the patient-centered medical home, which will play a critical role moving forward in utilizing team-based care.
“Our review shows that team approaches using nurse-managed protocols help improve health outcomes among patients with moderately severe diabetes, hypertension, and hyperlipidemia,” the study notes. “As the largest health care workforce group, nurses are in an ideal position to collaborate with other team members in the delivery of more accessible and effective chronic disease care. Team members, such as clinical pharmacists, may also be able to serve in similar capacities and in areas with limited health care resources.”