Table 2.
Overview of Health Professionals Used to Deliver Medication Interventions Using Protocols
| Article | Chronic Disease | Protocol Described in Article | Protocol Comments |
|---|---|---|---|
| Dietitian studies | |||
| Benson et al., 2019 (14) | Diabetes, dyslipidemia, and HTN | No | A treatment protocol used to initiate and titrate therapies for BG, HTN, and lipid levels in addition to providing medical nutrition therapy via telemedicine visits that supplemented usual care. |
| Worth et al., 2006 (30) | Dyslipidemia | Yes | A step-wise protocol was used to recommend, monitor, and titrate statin and fibrate therapy; the protocol had two pathways, one for primary prevention and one for secondary prevention. |
| Dietitian and nurse studies | |||
| Benson et al., 2018 (13) | Dyslipidemia and HTN | No | Primary CVD prevention; medication protocols outlined in earlier article by Benson et al. (33). |
| California Medi-Cal Type 2 Diabetes Study Group, 2004 (15) | Diabetes | No | Evidence-based practice guidelines and algorithms for medication and insulin initiation and/or adjustment used in a collaborative practice model with the primary care provider. |
| Senior et al., 2008 (27) | Diabetes, dyslipidemia, and HTN | Yes | Algorithms used as part of the protocol were included as supplement to the article. |
| Nurse studies | |||
| Courtenay et al., 2015 (16) | Diabetes | No | Nurse prescribers prescribed the same medicines as doctors if it was within their level of experience and competence. |
| Fanning et al., 2004 (17) | Diabetes, dyslipidemia, and HTN | Yes | Treatment algorithm for hyperglycemia was described in the article, but not the algorithms for dyslipidemia or HTN treatment. |
| Furler et al., 2017 (18) | Diabetes | Yes | The protocol describes the initiation and titration of basal insulin. |
| Houweling et al., 2011 (19) | Diabetes, dyslipidemia, and HTN | No | A detailed treatment protocol to prescribe 14 medications and adjust dosages for 30 more. |
| Houweling et al., 2009 (20) | Diabetes, dyslipidemia, and HTN | No | Diabetes specialty nurses were permitted to initiate therapy with 14 different medications and to change dosages for another 30 medications. |
| MacMahon et al., 2009 (21) | Diabetes, dyslipidemia, and HTN | Yes | Nurses titrated medication in response to BP and BG readings and biochemical results after patient visits to attain targets. |
| McLoughney et al., 2007 (22) | Diabetes, dyslipidemia, and HTN | No | Protocols for HTN, dyslipidemia, and other uncontrolled risk factors were produced in accordance with published guidelines. |
| New et al., 2003 (23) | Dyslipidemia and HTN | Yes | Medications for lipids and HTN were initiated and titrated according to a step-wise approach. |
| Ogedegbe et al., 2018 (24) | HTN | No | Protocols were detailed in the previously published study protocol (34). |
| Rudd et al., 2004 (25) | HTN | No | The nurse contacted the PCP for approval to initiate therapies and then used the protocol to titrate medications. |
| Senaratne et al., 2001 (26) | Dyslipidemia | Yes | A medication titration protocol was described clearly in the methods section. |
| Taylor et al., 2012 (28) | HTN | No | BP medication adjustments were made according to pre-arranged algorithms. |
| Tobe et al., 2006 (29) | HTN | Yes | A medication titration protocol was clearly described in the methods section. |
| Yip et al., 2018 (31) | HTN | No | A pre-developed HTN protocol was compared with usual care; if BP was normal, a repeat prescription pre-signed by the physician was issued; if BP was elevated, medication was prescribed; if BP remained high in 1 month, the physician was consulted. |
| Zgibor et al., 2018 (32) | Diabetes, dyslipidemia, and hypertension | Yes | Nurse CDEs used detailed medication intensification protocols available in the supplementary data. The protocol was found in an appendix to an earlier article by Zgibor et al. (35). |
BG, blood glucose; BP, blood pressure; CDE, certified diabetes educator; CVD, cardiovascular disease; HLD, hyperlipidemia; HTN, hypertension; SBP, systolic blood pressure.