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Cochrane Database of Systematic Reviews

Замена врачей медсестрами в первичном звене

Información

DOI:
https://doi.org/10.1002/14651858.CD001271.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 16 julio 2018see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Práctica y organización sanitaria efectivas

Copyright:
  1. Copyright © 2019 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration.
  2. This is an open access article under the terms of the Creative Commons Attribution‐Non‐Commercial Licence, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Autores

  • Miranda Laurant

    Correspondencia a: Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, Netherlands

    [email protected]

    Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, Netherlands

  • Mieke van der Biezen

    Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, Netherlands

  • Nancy Wijers

    Zorgbelang Gelderland, Arnhem, Netherlands

  • Kanokwaroon Watananirun

    Department of Obstetrics and Gynaecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Mahidol, Thailand

  • Evangelos Kontopantelis

    Centre for Health Informatics, Institute of Population Health, The University of Manchester, Manchester, UK

  • Anneke JAH van Vught

    Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, Netherlands

Contributions of authors

This review update was led by AvV and ML. ML, MvdB, NW, and AvV assessed studies for inclusion. ML, MvdB, NW, and AvV participated in data extraction and contributed to data analysis. AvV undertook the meta‐analysis with assistance from the other review authors. ML, MvdB, and AvV drafted the review, drawing on contributions from several review authors, and all review authors commented on this draft.

Sources of support

Internal sources

  • Centre for Quality of Care Research (WOK), University of Nijmegen, Netherlands.

  • National Primary Care Research and Development Centre (NPCRDC), University of Manchester, UK.

External sources

  • Ministry of Health, Welfare and Sports, Netherlands.

  • Department of Health, UK.

  • The Effective Health Care Research Consortium which is funded by UK aid from the UK Government for the benefit of developing countries, UK.

Declarations of interest

Miranda Laurant: none known.

Mieke van der Biezen: none known.

Nancy Wijers: none known.

Kanokwaroon Watananirun: none known.

Evangelos Kontopantelis: none known.

Anneke JAH van Vught: none known.

Acknowledgements

We thank the members of Cochrane Effective Practice and Organisation of Care for their valuable input during the update of this review. The Norwegian Satellite of the EPOC Group receives funding from the Norwegian Agency for Development Cooperation (Norad), via the Norwegian Institute of Public Health, to support review authors in the production of their reviews. We would like to thank Jan Odgaard‐Jenssen for his guidance, advice, and assistance with statistical meta‐analyses and sensitivity analyses. We thank Marit Johnson who advised on the search strategy and helped with computerised searches, as reported in this update. We would also like to acknowledge Simon Lewin for his appreciated editorial input into the updated review, as well as the following editors and peer referees, who provided comments to improve the protocol: Claire Glenton, Jane Noyes, Connor Emdin, and Claudia Maier; and to Dolores P. Matthews for copyediting this review.

We would like to acknowledge the following people, who were involved in the original review: Steve Rose and Richard Heywood, who advised on the search strategy and helped with computerised searches (original searches until 2002); Michelle Sergison and Bonnie Sibbald, who helped design the review and assisted with early data extraction; and Shirley Halliwell, who obtained study articles and helped to screen papers suitable for data extraction; David Reeves, who helped with statistical analysis in the original review (published in 2005). Finally, we have removed David Reeves, Rosella Hermens, Joze Braspennig, and Richard Grol as authors of this updated review, as owing to other obligations they lack sufficient time to commit to the process of this update. With regret, we have also removed Bonnie Sibbald from the list of review authors, as Bonnie was (together with Michelle Sergison and Miranda Laurant) one of the initiators of this systematic review and had been intensively involved in the review update until the time of her retirement. We would like to thank Bonnie for all of her input into this review until now.

The Effective Health Care Research Consortium provided funding to make this review open access. The Consortium is funded by UK aid from the UK Government for the benefit of developing countries (Grant: 5242). The views expressed in this review do not necessarily reflect UK government policy.

Version history

Published

Title

Stage

Authors

Version

2018 Jul 16

Nurses as substitutes for doctors in primary care

Review

Miranda Laurant, Mieke van der Biezen, Nancy Wijers, Kanokwaroon Watananirun, Evangelos Kontopantelis, Anneke JAH van Vught

https://doi.org/10.1002/14651858.CD001271.pub3

2005 Apr 20

Substitution of doctors by nurses in primary care

Review

Miranda Laurant, David Reeves, Rosella Hermens, Jose Braspenning, Richard Grol, Bonnie Sibbald

https://doi.org/10.1002/14651858.CD001271.pub2

1998 Oct 26

Substitution of doctors by nurses in Primary Care

Protocol

Miranda Laurant, Michelle Sergison, Bonnie Sibbald, David Reeves

https://doi.org/10.1002/14651858.CD001271

Differences between protocol and review

Because of the large number of available randomised trials, we excluded non‐randomised trials from this review (Laurant 2000).

In the next update, we will consider again (1) including subgroup analyses on differently trained nurses related to the level of training of participating nurses; and (2) pooling cost data from studies that reported costs.

We performed no statistical testing for funnel plot asymmetry, as none of the pooled outcomes included more than 10 studies. If more than 10 studies would be included, we will follow the recommendations provided in the Cochrane Handbook for Systematic Reviews of Interventions (Chapter 10.4.3.1.).

Change in authorship: We have added Anneke van Vught, Mieken van der Biezen, Nancy Wijers, Kanokwaroon Watananirun, and Evangelos Kontopantelis to the review author list. We have removed D. Reeves, R. Hermes, J. Braspenning, R. Grol, and B. Sibbald from the list of review authors (see Acknowledgements).

Notes

This is an update of the review “Substitution of doctors by nurses in primary care”, which was first published in 2005 for the Cochrane Library (Laurant 2005).

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.