—Alan Franciscus, Editor-in-Chief
While this is not specifically hepatitis C
related, anyone who has been seen by a medical provider for hepatitis C
has been touched by a nurse. Many times nurses are the ones who
provide the care and support. And as the hundreds of thousands of
people with hepatitis C are diagnosed and treated more and more of the
care will fall on the shoulders of nurses. As this article proves, one
of the most important members of a medical team is the nurse for
managing people with chronic conditions including those with hepatitis
C. – AF
Effects of Nurse-Managed
Protocols in the Outpatient Management of Adults With Chronic
Conditions: A Systematic Review and Meta-analysis.
Ryan J. Shaw et al.
in federal health policy are providing more access to medical care for
persons with chronic disease. Providing quality care may require a
team approach, which the American College of Physicians calls the
“medical home.” One new model may involve nurse-managed protocols.
determine whether nurse-managed protocols are effective for outpatient
management of adults with diabetes, hypertension, and hyperlipidemia.
Data Sources: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and CINAHL from January 1980 through January 2014.
Study Selection: Two
reviewers used eligibility criteria to assess all titles, abstracts,
and full texts and resolved disagreements by discussion or by
consulting a third reviewer.
Data Extraction: One reviewer did data abstractions and quality assessments, which were confirmed by a second reviewer.
Data Synthesis: From
2954 studies, 18 were included. All studies used a registered nurse or
equivalent who titrated medications by following a protocol. In a
meta-analysis, hemoglobin A1c level decreased by 0.4% (95% CI, 0.1% to
0.7%) (n = 8); systolic and diastolic blood pressure decreased
by 3.68 mm Hg (CI, 1.05 to 6.31 mm Hg) and 1.56 mm Hg (CI, 0.36 to
2.76 mm Hg), respectively (n = 12); total cholesterol level
decreased by 0.24 mmol/L (9.37 mg/dL) (CI, 0.54-mmol/L decrease to
0.05-mmol/L increase [20.77-mg/dL decrease to 2.02-mg/dL increase]) (n =
9); and low-density-lipoprotein cholesterol level decreased by 0.31
mmol/L (12.07 mg/dL) (CI, 0.73-mmol/L decrease to 0.11-mmol/L increase
[28.27-mg/dL decrease to 4.13-mg/dL increase]) (n = 6).
Limitation: Studies had limited descriptions of the interventions and protocols used.
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