BACKGROUND: In this study practice nurses with limited training provided care using a chronic disease management model.
AIM: To evaluate the impact of these nurses on the care of patients. Setting: Two group practices in the Midlands of England.
METHOD: The study used both qualitative and quantitative methods. For the qualitative study, the experiences of patients were examined using questionnaires and structured interviews. The experience of the nurses and the primary care teams was assessed using audio diaries and focus groups. For the quantitative study, a group of patients with depression cared for prior to the provision of the practice nurses was compared with a group of patients cared for after the practice nurses were in operation. Measures including the nature of assessment and adherence to prescribed medication were identified from clinical records for both groups of patients.
RESULTS: Patients valued the time and non-medical role of the nurses. The nurses greatly valued training and supervision. Acceptance of the role seemed to be better where there was already an integrated nursing team. The introduction of this role led to improved recording and to a limited improvement in measures of adherence to prescribed medication.