Table 2 Revision of professional roles
Author, number of studies | Quality score | Focus | Main results |
|---|---|---|---|
Beney 2000 N = 16 | 7 | Enlargement of the role of the public pharmacist | Changed use of healthcare services (PSI 6/6 = 100%). Improved patient outcomes (PSI 10/13 = 77%). No change in: quality of life. |
Bower 2000 N = 38 | 9 | Mental health workers in primary care: replacement of/consultation to primary care providers | *Replacement: lowered consultation rates (PSI 2/8 = 25%), short term reduction on psychotropic prescribing (PSI 4/11= 36%), long term changes psychotropic prescribing (PSI 3/6 = 50%), reduced mental health referrals (PSI 3/6 = 50%). *Consultation: more appropriate short term prescribing (PSI 3/6 = 50%). No change in: consultation rates, referral patterns. |
Brown 1995 N = 13 | 4 | Nurse practitioners in primary care | Improved laboratory testing (AES 0.20), resolution of pathological conditions (AES 0.28), patient satisfaction (AES 0.30). No change in: quality of care, prescribing, functional status, consultation rates, use of emergency service. |
Dijkstra 2004 N = 13 | 7 | Revision of professional roles for guideline implementation in hospitals | Improved professional performance (AOR 9.78, S). |
Horrocks 2002 N = 11 | 6 | Nurse practitioners in primary care | Improved patient satisfaction (SMD 0.27), longer consultations (WMD 3.67 minutes), more investigations (OR 1.22). No change in: health status. |
Loveman 2003 N = 6 | 8 | Specialist nurses in diabetes mellitus | No change in: HbA1c, emergency admissions, quality of life. |
Stone 2002 N = 20 | 6 | Organizational change (mainly involvement of non-physician staff and clinics devoted to prevention) to improve adult immunization and cancer screening | Improved preventive activities (AOR range 2.74 – 17.6). |
Smith 2001 N = 4 | 7 | Outreach nursing for chronic obstructive pulmonary disease | Increased hospital service utilization (PSI 2/2 = 100%). No change in: mortality, lung function, health related quality of life. |
Thompson 2003 N = 7 | 8 | Dietary advice by dietitians compared to self-management materials. | No change in: patient outcomes. |