Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice
Diann S. Eley A J , Elizabeth Patterson B , Jacqui Young C , Paul P. Fahey D , Chris B. Del Mar E , Desley G. Hegney F , Robyn L. Synnott A , Rosemary Mahomed G , Peter G. Baker H and Paul A. Scuffham I
+ Author Affiliations
- Author Affiliations
A School of Medicine, The University of Queensland, 288 Herston Road, Brisbane, Qld 4006, Australia.
B Department of Nursing, Level 3, Walter Boas Building, The University of Melbourne, Grattan Street, Carlton, Vic. 3010, Australia.
C School of Nursing and Midwifery, Edith Cavell Building, Herston Campus, The University of Queensland, Qld 4029, Australia.
D School of Nursing and Midwifery, The University of Queensland, 288 Herston Road, Brisbane, Qld 4006, Australia.
E Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld 4229, Australia.
F School of Population Health, Centre for Nursing Research, Sir Charles Gairdner Hospital, Mail Drop M431, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
G School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4215, Australia.
H Rural Clinical School, The University of Queensland, Toowoomba, Qld 4050, Australia.
I School of Medicine, Griffith University Logan Campus, University Drive, Meadowbrook, Qld 4131, Australia.
J Corresponding author. Email: d.eley@uq.edu.au
Australian Journal of Primary Health 19(2) 150-158 https://doi.org/10.1071/PY11164
Submitted: 7 October 2011 Accepted: 13 April 2012 Published: 8 May 2012
Abstract
The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model’s feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients’ stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.
Additional keywords: practice nursing, quality of life.
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