Nurse care improves control of chronic conditions

Nurses can improve control of glycaemia, blood pressure and lipids by titrating medication, according to a new meta-analysis.

During each of the 18 studies included in the meta-analysis, a nurse titrated medications by following a protocol. In 17 studies, usual care acted as the control. The meta-analysis reported that haemoglobin A1c decreased by 0.4% in patients managed by nurses compared with controls. Systolic and diastolic blood pressure decreased by 3.68 and 1.56 mmHg respectively. Total and low-density lipoprotein (LDL) cholesterol decreased by 0.24 mmol/L (9.37 mg/dL) and 0.31 mmol/L (12.07 mg/dL) respectively.

Nurses also produced 'an overall pattern of small positive effects' on lifestyle changes and medication adherence, although few studies examined these outcomes. However, there was insufficient data to assess nurses' impact on several other outcomes, including adverse events and resource use.