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Nurses can manage people with well controlled asthma

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1393 (Published 06 March 2013) Cite this as: BMJ 2013;346:f1393

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Patients with well controlled asthma seem to do equally well when managed primarily by nurses or by doctors, say researchers from the Netherlands. In a systematic review of five good quality randomised trials, participants managed either way had comparable symptoms, quality of life, and lung function. They had similar rates of hospital admissions and exacerbations during follow-up. Nurses were a little cheaper in the one trial that included costs, although the saving on personnel didn’t translate into lower healthcare costs overall. Patients may get more contact time with nurses, and good economic evaluations should be done alongside future trials, say the authors.

The five trials and 588 patients in their review compared care led by doctors with care led by any nursing professional, such as an asthma nurse or nurse practitioner. Trials were conducted in primary care (two), hospital outpatient clinics (two), or both (one); three trials studied adults and two studied children. Three of the trials came from the Netherlands, and the authors urge policy makers outside Europe to look for confirmation in other health systems. Policy makers everywhere need more evidence on nurse led care for patients without such good control of their asthma. These authors found just one trial of 154 adults recruited soon after an exacerbation. Again, those managed by nurses or doctors had a comparable risk of further exacerbations.

Notes

Cite this as: BMJ 2013;346:f1393