People with chronic disease can benefit from self-management support provided by nurses in the community

Massimi A, De VC, Brufola I, et al.  Est-ce que les interventions communautaires de soutien à l'autogestion dirigées par des infirmières sont efficaces chez les patients atteints de maladies chroniques? Les résultats d'une revue systématique et d'une méta-analyse  PLoS One. 2017 March. 12(3): e0173617

Review question

• For patients with chronic disease, is self-management support provided by community-based nurses effective compared to usual care in terms of health outcomes such as blood pressure, glucose levels and quality of life?

Background

• As more people age and develop chronic illnesses, costs increase and the burden on primary care services continues to increase. As such, great emphasis has been placed on educational interventions such as self-management for chronic-disease patients.

• Transferring tasks from physicians to specially trained nurses is a promising way to administer educational interventions focused on the self-management of chronic diseases while reducing workload for physicians.

• Although there are individual studies on this topic, this is the first systematic review that aims to identify specific characteristics that may make interventions more effective.

How the review was done

• A detailed search of a number of electronic databases for studies published up to July 2016 was conducted. Studies that focused on nurse-led self-management support interventions in a community setting for patients 18 years and older with a diagnosis of chronic disease were included in the review.

• A total of 7,279 studies were identified in searches, and 23 were included in the review after assessments for eligibility.

• The authors did not acknowledge any funding sources for this review.

What the researchers found

• Researchers found that nurse-led self-management support interventions in chronic-care community programs have an affect on reducing blood pressure.

• While this approach lead to a reduction in measurements of blood sugar levels, a reduction in fasted blood sugar levels was not strongly supported.

• Other blood levels and quality-of-life outcomes were inconclusive.

• Furthermore, researchers found that those with diabetes and coronary vascular disease can benefit most from nurse-led self-management.

Conclusion

• Community-based nurse-led self-management programs have shown to be helpful in educating patients with diabetes and coronary vascular disease, particularly in supporting them to manage blood pressure and long-term blood sugar levels.