Nurses managing type 2 diabetes will require significant change

Nurses in general practice who manage type2 diabetes patients are under-resourced a new University of Melbourne study shows.

To mark World Diabetes day, (14 November) University of Melbourne researcher Dr Irene Blackberry, a Research Fellow from the General Practice and Primary Health Care Academic Centre, said the study suggested that generalist nurses located within general practices are under resourced and time-poor, making a role in chronic disease management difficult.

Published recently in the British Medical Journal, a trial of nurse-led telephone coaching for patients with type 2 diabetes failed to demonstrate blood sugar improvement over 18 months.

Researchers used The Patient Engagement and Coaching for Health (PEACH) program as a model of telephone coaching which has been effective in hospital patients after an acute cardiac episode.

"We wanted to find out if telephone coaching by nurses in general practice could improve clinical and psychosocial outcomes for patients with type 2 diabetes," said Dr Blackberry.

"Results revealed many of the nurses in the trial were unable to complete the full number of coaching appointments due to time issues. We think the trial outcome was reflective of generalist nurses having time restraints and lack of on-going training. We also think the absence of prescribing or even medication adjustment rights may have played a role," she said.

"We need a change in the organisational care delivery to support practice nurses to get the best outcome for patients. Further research is needed in this area of health care to improve practice and policy implementation."

During the World Diabetes Congress Melbourne 2013, the University of Melbourne will be conducting a symposium.

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