Table 3.
Effect estimates of studies in review
| Study | Nurses’ role | Population diagnosis | Outcome | Measurement method/scale | FUP, months | Nurse group | Physician group | Effect estimate | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| First author, y | Location | ||||||||||
| Binary data | n | N | n | N | RR (95 % CI) | ||||||
| Heart disease | |||||||||||
| Andryukhin et al., 2011 [18] | RU 1 | NP/LN | Heart failure PEF | Positiveb changes in class HF | NYHA | 6 | 18 | 40 | 8 | 35 | 1.97 (0.98 to 3.96) |
| Campbell et al., 1998 [19–21, 29–31, 33] | UK 1 | NP | CHD secondary prevention | Chest pain | ATyPeS/SF36a | 12 | 232 | 508 | 250 | 498 | 0.91 (0.80 to 1.04) |
| Campbell et al., 1998 [19–21, 29–31, 33] | UK 1 | NP | CHD secondary prevention | Chest pain | ATyPeS/SF36 | 48 | 147 | 430 | 129 | 385 | 1.02 (0.84 to 1.24) |
| Campbell et al., 1998 [19–21, 29–31, 33] | UK 1 | NP | CHD secondary prevention | Worsening chest pain | ATyPeS/SF36 | 12 | 37 | 519 | 54 | 500 | 0.66 (0.44 to 0.98) |
| Campbell et al., 1998 [19–21, 29–31, 33] | UK 1 | NP | CHD secondary prevention | Worsening chest pain | ATyPeS/SF36 | 48 | 44 | 439 | 35 | 395 | 1.13 (0.74 to 1.73) |
| Lung disease | |||||||||||
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | No chronic cough and phlegm production or an improvement | Present/absent | 12 | 43 | 108 | 39 | 85 | 0.87 (0.63 to 1.20) |
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | No chronic cough and phlegm production or an improvement | Present/absent | 24 | 41 | 93 | 33 | 79 | 1.06 (0.75 to 1.49) |
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | No wheezing or an improvement in frequency | Never, ever, most days and night | 12 | 68 | 106 | 51 | 85 | 1.07 (0.85 to 1.34) |
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | No wheezing or an improvement in frequency | Never, ever, most days and night | 24 | 53 | 93 | 37 | 79 | 1.22 (0.91 to 1.63) |
| Infectious disease | |||||||||||
| Fairall et al., 2012 [25] | ZA 2 | LN | HIV/AIDS | Suppressed viral load in patients receiving ARTd | Viral load | 12–18 | 2156 | 3029 | 2230 | 3202 | 1.02 (0.99 to 1.06) |
| Fairall et al., 2012 [25] | ZA 1 | LN | HIV/AIDS | Suppressed viral load in patients starting ARTd | Viral load | 12–18 | 1706 | 2375 | 1062 | 1449 | 0.98 (0.94 to 1.02) |
| Diverse, acute and minor conditions | |||||||||||
| Shum et al., 2000 [32] | UK 2 | NP | Acute and minor | Same, improved or cured self-reported health status | Murphy | 0.5 | 650 | 672 | 646 | 661 | 0.99 (0.97 to 1.01) |
| Kinnersley et al., 2000 [34] | UK 3 | NP | Diverse conditions | Same or improved symptoms (much better, better or unchanged) | Likert-type and single reminders | 0.5 | 472 | 484 | 515 | 529 | 1.00 (0.98 to 1.02) |
| Continuous data | Mean (SD) | N | Mean (SD) | N | WMD (95 % CI) | ||||||
| Lung disease | |||||||||||
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | Mean change score in dyspnea | MRCQTc | 12 | 0.00 (1.3) | 115 | 0.10 (1.3) | 94 | −0.10 (−0.45 to 0.25) |
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | Mean change score in dyspnea | MRCQTc | 24 | 0.20 (1.4) | 96 | 0.30 (1.3) | 80 | −0.10 (−0.50 to 0.30) |
| Metabolic disease | |||||||||||
| Denver et al., 2003 [23] | UK 5 | NP+ | DM2 with hypertension, under BPLT | Mean fall in 10-year CHD risk | Framingham CHD risk score | 6 | −2.33 (3.87) | 59 | −0.33 (2.16) | 56 | −2.00 (−3.14 to −0.86) |
| Denver et al., 2003 [23] | UK 5 | NP+ | DM2 with hypertension, under BPLT | Mean fall in 10-year stroke risk | Framingham stroke risk score | 6 | −4.33 (6.0) | 59 | −1.80 (3.53) | 56 | −2.53 (−4.32 to −0.74) |
| Digestive disease | |||||||||||
| Chan et al., 2009 [22] | UK 6 | NP+ | GORD, moderate gastritis | Mean score, dyspepsia severity | GDSS (Gladys) scoreg | 6 | 4.90 (2.9) | 89 | 7.20 (3.1) | 86 | −2.30 (−3.19 to −1.41) |
| Skin disease | |||||||||||
| Kernick et al., 2000 [28] | UK 4 | NP+ | Psoriasis/eczema | Mean score for symptoms and severity of skin condition | Self-evaluation clinical scoree | 4 | 7.60 (3.3) | 35 | 8.1 (3.3) | 46 | −0.50 (−1.95 to 0.95) |
| Common complaints | |||||||||||
| Dierick-van Daele et al., 2009 [24] | NL 2 | NP+ | Common complaints | Mean difference in the degree of burden of illness | LikertQTf | 0.5 | −1.77 (3.18) | 473 | −1.50 (2.63) | 451 | −0.27 (−0.65 to 0.11) |
| Dierick-van Daele et al., 2009 [24] | NL 2 | NP+ | Common complaints | Mean difference in the concerns about illness | LikertQTf | 0.5 | −1.51 (3.20) | 476 | −1.40 (2.97) | 450 | −0.11 (−0.51 to 0.29) |
| Qualitative data | |||||||||||
| Metabolic disease | |||||||||||
| Houweling et al., 2011 [27] | NL 3 | NP | DM2 | Perceived burden of DM symptoms and rating of symptom troublesomeness | Type 2 Diabetes Symptom Checklisth | 14 | “significant differences at follow-up for some of the Diabetes Symptom Score dimensions (data not shown). After 14 months, the mean sub-dimension scores for DM symptoms ‘fatigue’ and ‘cognitive distress’ and the total scores were lower in each group, although no difference was observed between the groups.” | ||||
| Lung disease | |||||||||||
| Hesselink et al., 2004 [26] | NL 1 | LN | Asthma/COPD | Respiratory complaints within two weeks after intervention | Disturbance (present/absent) for >1 day or night | 0.5 | “no significant group differences in the number of days or nights disturbed, OR 0.96 (95 % CI 0.56 to 1.61)” | ||||
| Common complaints | |||||||||||
| Dierick-van Daele et al., 2009 [24] | NL 2 | NP+ | Common complaints | Complications due to illness | Mean number of days of work absence | 0.5 | “1.11 days (nurse, SD 0.32; physician, SD 0.31) of work absence in average” | ||||
| Dierick-van Daele et al., 2009 [24] | NL 2 | NP+ | Common complaints | Complications due illness | Mean number of days of inability for daily activities | 0.5 | “no statistically significant differences between groups; mean days unable for daily activities: nurse-led care 2.53 (SD 2.89), physician-led care 2.69 (SD 2.90)” | ||||
Studies are listed in order of increasing length of follow-up, within each category of outcomes
UK: United Kingdom; NL: the Netherlands; ZA: South Africa; RU: Russia; n: number of patients or number of events; N: total number of patients per group; SD: standard deviation; RR: relative risk; WMD: weighted mean difference; CI: confidence intervals; DM(2): diabetes mellitus (type 2); GORD: gastro-esophageal reflux disease; COPD: chronic obstructive pulmonary disease; CHD: coronary heart disease; BPLT: blood pressure lowering treatment; PEF: preserved ejection fraction; MRCQT: Medical Research Council Questionnaire; LikertQT: Likert-type questionnaire; GDSS: Glasgow Dyspepsia Severity Score (Gladys); NYHA: New York Heart Association Functional Classification; ATyPeS: Angina TyPe specification scale
aATyPeS is designed to use with the SF36 questionnaire to assess the presence, frequency and course of chest pain
bPositive changes mean regression of class or stay within class I of NYHA
cMRCQT ranking from 0 (no dyspnea) to 4 (very serious); positive mean values in each group indicate improvement; mean differences with negative values mean a reduction or improvement
dZA1 trial: patients starting ART whose results were available for at least 6 months. ZA2 trial: 76 % and 78 % of the patients in the intervention and control group, respectively, had been receiving ART for at least 2 years at the time of viral load measurements
eThree out of eight possible symptoms, each ranked from 1 (mild) to 5 (very severe). The sum score gave a clinical score from 3 (best state) to 15 (worst)
fLikert-type questionnaire ranking from 0 (excellent) to 10 (poor/worse); mean differences with negative values mean a reduction or improvement
gGDSS (Gladys) ranking from 0 (no symptoms) to 20 (symptoms)
h34-item scale based on yes/no questionnaires for perceived burden of symptoms including hyperglycemic, hypoglycemic, cardiac, neuropathic, psychological and vision-related. Summary responses ranked from 1 (symptom not occurred or not perceived as troublesome) to 5 (symptom extremely troublesome) on Likert-type scale