Practice nurse involvement in the management of adults with type 2 diabetes mellitus attending a general practice: results from a systematic review

Parker, Deborah, Maresco-Pennisi, Diane, Clifton, Karen, Shams, Ridhwan and Young, Jacqui (2016) Practice nurse involvement in the management of adults with type 2 diabetes mellitus attending a general practice: results from a systematic review. International Journal of Evidence-Based Healthcare, 14 2: 41-52. doi:10.1097/XEB.0000000000000080


Author Parker, Deborah
Maresco-Pennisi, Diane
Clifton, Karen
Shams, Ridhwan
Young, Jacqui
Title Practice nurse involvement in the management of adults with type 2 diabetes mellitus attending a general practice: results from a systematic review
Journal name International Journal of Evidence-Based Healthcare   Check publisher's open access policy
ISSN 1744-1595
1744-1609
Publication date 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/XEB.0000000000000080
Volume 14
Issue 2
Start page 41
End page 52
Total pages 12
Place of publication Philadelphia, United States
Publisher Wolters Kluwer Health
Collection year 2017
Language eng
Formatted abstract
Aim: Using the methodology of the Joanna Briggs Institute, a systematic review of current research was performed to determine if the addition of management by nurses had been more effective in improving clinical outcomes of patients with type 2 diabetes attending a general practice compared with standard care. 

Methods: A three-step literature search was conducted for suitable English studies with quantitative clinical outcomes that had been published from January 1990 to May 2014. Randomised controlled trials (RCTs) were particularly sought after; however, other research designs were considered. Articles were assessed by two independent reviewers for methodological validity, prior to inclusion in the review, using standardised critical appraisal instruments from the Joanna Briggs Institute. When possible, quantitative data were pooled in statistical meta-analysis.

Results: Seven studies were of suitable quality and relevance for the review: these included three randomised control trials; two cluster- RCTs; a cluster, nonrandomised, controlled before-after study; and a cluster observational cohort study. These studies yield evidence that nurse management in addition to standard general practitioner care leads to modest improvements in blood pressure and total cholesterol levels in adults with type 2 diabetes attending a general practice. 

Conclusion: Meta-analysis identified modest, significant improvements amongst participants in nurse management interventions (NMIs) in the following clinical outcomes: mean SBP, mean DBP and mean total cholesterol. The majority of outcomes studied did not show any advantage to adding NMIs to general practitioner care. Two studies reported significant improvements of participants with poor control in mean haemoglobin A1c. An RCT that investigates the effect of NMIs on patients, with poor control in regard to clinical outcomes and cost effectiveness, is recommended.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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Created: Thu, 28 Apr 2016, 21:36:00 EST by Dr Jacqui Young on behalf of School of Nursing, Midwifery and Social Work