Impacts of nurse-led clinic and nurse-led prescription on hemoglobin A1c control in type 2 diabetes

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background:

To evaluate the impacts of nurse-led clinic and nurse-led prescription on hemoglobin A1c (HbA1c) control in type 2 diabetes.

Methods:

We searched relevant publications in English and Chinese database and conducted meta-analysis by Stata 12.0. We divided the case groups of included studies into 2 categories according to the role of nurse: nurse-led clinic and nurse-led prescription. Nurse-led clinic was implemented on the basis of standard diabetes care provided by doctor, and control group also receive the standard diabetes care but without nurse-led clinic. The doctor mentioned above might work alone or in a health care team. Nurse-led prescription was prescribed by nurse independently and compared with that of doctor.

Results:

The meta-analysis shown that, compared with the standard diabetes care, nurse-led clinic significantly decreases HbA1c level (standard mean difference [SMD] = −0.767; 95% confidence interval [CI]: −1.062, −0.471; P < .001). In subgroup analysis, nurse-led clinic also had positive impacts on controlling HbA1c level, no matter in developed countries (SMD = −0.353; 95% CI: −0.6, −0.106; P = .005) or developing countries (SMD = −1.114; 95% CI: −1.498, −0.73; P < .001). Additionally, there was no significant difference between nurse-led prescription and doctor prescription in controlling HbA1c levels (SMD = −0.203; 95% CI: −0.434, 0.029; P = .086).

Conclusion:

The nurse-led clinic had positive significance for HbA1c control. Meanwhile, the impact of nurse-led prescription on controlling HbA1c is comparable to that of doctor. It is valuable to provide nurse-led clinic on the basis of standard diabetes care provided by doctor to better control HbA1c, and nurse-led prescription should be provided when doctor-led service is limited.

Related collections

Most cited references 26

Record: found
Abstract: found
Article: not found

The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis

Michael Roerecke, Jürgen Rehm, Gerrit Gmel … (2017)

Although it is well established that heavy alcohol consumption increases the risk of hypertension, little is known about the effect of a reduction of alcohol intake on blood pressure. We aimed to assess the effect of a reduction in alcohol consumption on change in blood pressure stratified by initial amount of alcohol consumption and sex in adults.

0 comments Cited 147 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Link between type 2 diabetes and Alzheimer’s disease: from epidemiology to mechanism and treatment

Xiaohua Li, Dalin Song, Sean X Leng (2015)

The aim of this paper is to provide a comprehensive review of the epidemiological evidence linking type 2 diabetes mellitus and its related conditions, including obesity, hyperinsulinemia, and metabolic syndrome, to Alzheimer’s disease (AD). Several mechanisms could help to explain this proposed link; however, our focus is on insulin resistance and deficiency. Studies have shown that insulin resistance and deficiency can interact with amyloid-β protein and tau protein phosphorylation, each leading to the onset and development of AD. Based on those epidemiological data and basic research, it was recently proposed that AD can be considered as “type 3 diabetes”. Special attention has been paid to determining whether antidiabetic agents might be effective in treating AD. There has been much research both experimental and clinical on this topic. We mainly discuss the clinical trials on insulin, metformin, thiazolidinediones, glucagon-like peptide-1 receptor agonists, and dipeptidyl peptidase-4 inhibitors in the treatment of AD. Although the results of these trials seem to be contradictory, this approach is also full of promise. It is worth mentioning that the therapeutic effects of these drugs are influenced by the apolipoprotein E (APOE)-ε4 genotype. Patients without the APOE-ε4 allele showed better treatment effects than those with this allele.

0 comments Cited 94 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Physician - nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.

David Litaker, Lorraine Mion, Loretta Planavsky … (2003)

Increasing demand to deliver and document therapeutic and preventive care sharpens the need for disease management strategies that accomplish these goals efficiently while preserving quality of care. The purpose of this study was to compare selected outcomes for a new chronic disease management program involving a nurse practitioner - physician team with those of an existing model of care. One hundred fifty-seven patients with hypertension and diabetes mellitus were randomly assigned to their primary care physician and a nurse practitioner or their primary care physician alone. Costs for personnel directly involved in patient management, calculated from hourly rates and encounter time with patients, and pre- and post-study glycosylated hemoglobin (HbA(1c)), high-density lipoprotein cholesterol (HDL-c), satisfaction with care and health-related quality of life (HRQoL) were assessed. Although 1-year costs for personnel were higher in the team-treated group, participants experienced significant improvements in mean HbA(1c) ( - 0.7%, p = 0.02) and HDL-c ( + 2.6 mg dL( - 1), p = 0.02). Additionally, satisfaction with care improved significantly for team-treated subjects in several sub-scales whereas the mean change over time in HRQoL did not differ significantly between groups. This study demonstrates the value of a complementary team approach to chronic disease management in improving patient-derived and clinical outcomes at modest incremental costs.

0 comments Cited 53 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: June 2019

Publication date (Electronic): 07 June 2019

Volume: 98

Issue: 23

Electronic Location Identifier: e15971

Affiliations

[a ]Department of Nursing, Huzhou Wuxing Hospital of Integrated Traditional Chinese and Western Medicine

[b ]Department of Internal Medicine, The First Affiliated Hospital of Huzhou University

[c ]Department of Internal Medicine

[d ]Department of Nursing, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Huzhou, Zhejiang, China.

Author notes

[∗ ]Correspondence: Xiaohua Li, Department of Nursing, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Huzhou, Zhejiang, China (e-mail: xiaohualihz@ 123456126.com ).

Article

Publisher ID: MD-D-18-06669 Accession ID: 15971

DOI: 10.1097/MD.0000000000015971

PMC ID: 6571354

PubMed ID: 31169727

SO-VID: da8de160-b4ef-4576-8779-26c3889bf94d

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 15 September 2018

Date revision received : 24 March 2019

Date accepted : 15 May 2019

Custom metadata

OPEN-ACCESS TRUE

Keywords: hemoglobin a1c,meta-analysis,nurse,type 2 diabetes

Data availability:

Keywords: hemoglobin a1c, meta-analysis, nurse, type 2 diabetes

Comments

Comment on this article

scite_

Cited by 5

See all cited by

Most referenced authors 650

See all reference authors

Impacts of nurse-led clinic and nurse-led prescription on hemoglobin A1c control in type 2 diabetes : A meta-analysis

Read this article at

Abstract

Background:

Methods:

Results:

Conclusion:

Related collections

Telehealth & Medicine Today

Most cited references 26

The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis

Link between type 2 diabetes and Alzheimer’s disease: from epidemiology to mechanism and treatment

Physician - nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 456

Cited by 5

Most referenced authors 650