Therapeutic effect of nurse-led clinics in patients with T2DM: a systematic review

Abstract

Objective To evaluate the therapeutic effect of nurse-led clinics (NLCs) in patients with type 2 diabetes mellitus (T2DM). Methods We searched randomized controlled trials (RCTs) related to the therapeutic effect of patients with T2DM in PubMed, EMBASE, CENTRAL, Web of science, CBM, CNKI, VIP, and Wanfang databases from the beginning to June 2016. The methodological quality was used to assess the included studies according to bias risk assessment recommended by Cochrane Handbook 5.1.0 software, and the data were extracted and analyzed by using the RevMan 5.1 software. Results Totally 15 RCTs with 2 204 patients were included in this study. The Meta-analysis showed that: compared with the control group, NLC intervention can further decrease the HbA1c level of patients with T2DM [MD=-1.11, 95%CI(-1.47, -0.75), P<0.001]; improve patients′ adherence to medication [RR=1.28, 95%CI(1.20, 1.35)], diet control [RR=1.68, 95%CI(1.52, 1.86)], exercise reinforcement [RR=1.32, 95%CI(1.22, 1.43)], and regular blood glucose monitoring [RR=1.68, 95%CI(1.30, 2.17)]; and improve patients′ quality of life. Meta-regression analysis showed that the effect of NLC were positively related to the baseline level of HbA1c (r=-0.33, P<0.05). Conclusions The application of NLC can improve the therapeutic effect of patients with T2DM, and improve their treatment compliance and quality of life. Key words: Meta-analysis; Diabetes mellitus, type 2; Nurse-led clinic; Systematic review