Abstract
Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Chen L, Farwell W, Jha A. Primary care visit duration and quality: does good care take longer? Arch Int Med. 2009;169:1866–72.
McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635–45.
Bodenheimer T, Chen E, Bennett HD. Confronting the growing burden of chronic disease: can the U.S. health care workforce do the job? Health Aff (Millwood). 2009;28:64–74.
Department of Veterans Affairs-Quality Enhancement Research Initiative VHA QUERI REVIEW. Effects of Nurse-Managed Protocols in the Outpatient Management of Adults with Chronic Conditions. August 2013. Accessed 20 Mar 2014. http://www.hsrd.research.va.gov/publications/management_briefs/eBrief-no72.cfm. This report compiles an objective review based on the strength of the evidence of Nurse - Managed Protocol use in outpatient chronic disease management.
Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control. JAMA. 2006;296:427–40.
Khunti K, Wolden ML, Thorsted BL, et al. Clinical inertia in people with type 2 diabetes a retrospective cohort study of more than 80,000 people. Diabetes Care/Case. 2013;1–7. [Published ahead of print]. Published online July 22, 2013.
Sutherland D, Hayter M. Structured review: evaluating the effectiveness of nurse case managers in improving health outcomes in three major chronic diseases. J Clin Nurs. 2009;18:2978–92. [serial online]. Accessed October 3, 2013. Available at: MEDLINE with Full Text, Ipswich, MA.
Krein SL, Klamenis ML, Vijan S, et al. Case management for patients with poorly controlled diabetes. A randomized control trial. Am J Med. 2004;116:732–9.
Loveman E, Royle P, Waugh N. Specialist nurses in diabetes mellitus. 2009. Available at: The Cochrane Library. Accessed 17 October 2013.
Clark CE, Smith LF, Taylor RS, Campbell JL. Nurse-led interventions used to improve control of high blood pressure in people with diabetes: a systematic review and meta-analysis. Diabet Med. 2011;28:250–61. This recent systematic review and meta-analysis addresses blood pressure control in people with diabetes.
Egginton JS, Ridgeway JL, Shah ND, et al. Care management for Type 2 diabetes in the United States: a systematic review and meta-analysis. BMC Health Serv Res. 2012;12:1–9.
Aubert RE, Herman WH, Waters J, et al. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization. a randomized, controlled trial. Ann Intern Med. 1998;129:605–12.
Fischer HH, Eisert SL, Everhart RM, et al. Nurse-run telephone-based outreach to improve lipids in people with diabetes. Am J Manag Care. 2012;18:77–84.
New JP, Mason JM, Freemantle N, et al. Specialist nurse–led intervention to treat and control hypertension and hyperlipidemia in diabetes (SPLINT). Diabetes Care. 2003;26:2250–5.
Taylor CB, Miller NH, Reilly KR, et al. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabetes Care. 2003;26:1058–63.
Houweling ST, Kleefstra N, van Hateren KJJ, et al. Diabetes specialist nurse as main care provider for patients with type 2 diabetes. Neth J Med. 2009;67:279–84.
Ishani A, Greer N, Taylor BC, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care. 2011;34:1689–94. This RCT study shows improvement of cardiovascular risk factors for patients with diabetes in the Veterans Health Administration.
California Medi-Cal Type 2 Diabetes Study Group. Diabetes Study Group. Closing the gap: effect of diabetes case management on glycemic control among low-income ethnic minority populations. Diabetes Care. 2004;27:95–103.
Pettitt DS, Wollitzer O, Jovanovic L, et al. Decreasing the risk of diabetic retinopary in a study of case management: California Medi-cal type 2 diabetes study. Diabetes Care. 2005;28:2819–22.
Vrijhoef HJM, Diederiks JPM, Spreeuwenberg C, et al. Substitution model with central role for nurse specialist is justified in the care for stable type 2 diabetic outpatients. J Adv Nurs. 2001;36:546–55.
Dorr DA, Wilcox A, Donnelly SM, et al. Impact of generalist care managers with diabetes. Health Serv Res. 2005;40:1400–21.
Davidson MB, Blanco-Castellanos M, Duran P. Integrating nurse-directed diabetes management into a primary care setting. Am J Manag Care. 2010;16:652–6. [Published Online]. Accessed November 3, 2013.
Kennedy L, Herman WH, Strange P, et al. Impact of active versus usual algorithmic titration of basal insulin and point-of-care versus laboratory measurement of HbA1C on glycemic control in patients with type 2 diabetes. Diabetes Care. 2006;29:1–8.
Watts SA, Lawrence RH, Kern K. Diabetes nurse case management training program: enhancing care consistent with the chronic care and patient-centered medical home models. Clin Diabetes. 2011;29:25–33.
Compliance with Ethics Guidelines
Conflict of Interest
Sharon A. Watts and Michelle Lucatorto declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Health Care Delivery Systems in Diabetes
Rights and permissions
About this article
Cite this article
Watts, S.A., Lucatorto, M. A Review of Recent Literature - Nurse Case Managers in Diabetes Care: Equivalent or Better Outcomes Compared to Primary Care Providers. Curr Diab Rep 14, 504 (2014). https://doi.org/10.1007/s11892-014-0504-2
Published:
DOI: https://doi.org/10.1007/s11892-014-0504-2