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Management of Diabetes by Prescribing vs. Non-Prescribing Nurses

Findings show longer relationships and longer consultations between prescribing nurses and diabetic patients.

Researcher Molly Courtenay, PhD, Professor of Health Sciences in the College of Biomedical and Life Sciences at Cardiff University, and her colleagues report that 30% of more than 28,000 prescribing nurses in the U.K. take care of diabetic patients predominantly in the general practice setting. Considering the key role that nurses play in the care of diabetes patients, researchers were interested in studying the associated clinical outcomes.

This study was conducted to compare prescribing and non-prescribing nurses in managing people with diabetes with respect to patient characteristics, activities and processes of care, patient outcomes (self-management, clinical indicators, satisfaction), and resource implications and costs.

For the study, 214 patients with T2DM who received care at one of 12 general practices in England were recruited (131 patients recruited by prescribing nurses; 83 patients recruited by six non-prescribing nurses). All subjects were adults on oral hypoglycemic medication, insulin, or both who had been receiving care from that nurse for a minimum of one year. These participants were followed up for 6 months during 2011 to 2012.

This comparative case study published in the Journal of Advanced Nursing showed that T2DM patients have similar clinical outcomes regardless of the prescribing ability of the nurse. Furthermore, similar outcomes were apparent even when prescribing nurses were compared to doctors who prescribed the same drug.

Authors believe that there are no differences in self-care activities or HbA1c results among either group. However, authors claim that the mean HbA1c levels decreased significantly in both groups over a period of 6 months. Patients who were taken care of by prescribing nurses reported more satisfaction, and also had longer consultation duration by an average of 8 minutes. On the other hand, patients of non-prescribing nurses required support from other healthcare professionals more regularly. Lastly, authors report that prescribing nurses received higher salaries compared to non-prescribing nurses.

Practice Pearls:

  • Clinical outcomes of diabetes patients managed by prescribing and non-prescribing nurses are similar.
  • Prescribing nurses tend to have longer relationships with their patients and longer duration of consultations; thereby, resulting in higher patient satisfaction.
  • Prescribing nurses may require higher salaries; however, clinical settings should consider hiring a prescriber if they are going to utilize the nurses’ skills appropriately.
  • “Evidence suggests that nurse prescribers are safe, prescribe clinically appropriate medicines, enable patients to access treatment faster, and result in patients satisfied with their care.”

Courtenay, Molly, et al. “A comparison of prescribing and non‐prescribing nurses in the management of people with diabetes.” Journal of Advanced Nursing (Oct. 2015).