RESEARCH 912 REPRINTED FROM AFP VOL.45, NO.12, DECEMBER 2016 © The Royal Australian College of General Practitioners 2016 A nurse-led model of chronic disease management in general practice: Patients’ perspectives Jacqui Young, Diann Eley, Elizabeth Patterson, Catherine Turner t is estimated that chronic diseases are responsible for 68% of all deaths globally. 1 This trend is also evident in Australia, where cardiovascular disease is the single largest cause of mortality, accounting for >34% of all deaths. 2 In addition, it is estimated that 280 Australians develop diabetes every day. 3 The majority of chronic disease management in Australia is carried out in general practice, with the general practitioner (GP) being the main caregiver. 4 The landscape of Australian general practice has changed over the past decade. Nurses are now employed in 63.3% of general practices 5 and are given the title ‘practice nurse’ (PN). 6 However, it is argued that PNs in Australia are underused, 7 and that there is an overreliance on PNs performing simple clinical skills. Chronic disease management has become a large and growing component of general practice, and changing models of care have evolved. International research suggests that extending the role of PNs and adopting nurse-led models of care have benefcial effects on patient satisfaction, clinical outcomes and quality of life. 8,9 It has been suggested that PNs may be better at routine maintenance and monitoring of patients with stable chronic diseases, and that they are better at using evidence-based guidelines such as clinical protocols. 10 Therefore, this may offer an opportunity for improving the care Background Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. Objective The objective of this article is to examine patients’ perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. Method This article reports on the second phase of a mixed-methods study in which semi- structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care. Results Three themes emerged from the data – time, ambiance and dimensions of the nurse role. Discussion The results suggest that general practice nurses had a positive impact on patients’ ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases. of patients with chronic disease, which has been assessed as being less than optimal. 11 Methods This study used a sequential explanatory mixed methods design. This article reports on the second stage of the study and attempted to answer the following research question ‘What are patients’ perceptions of PN-led care and does this care impact on their health?’. Design This study was nested within a larger (main) study that compared GP-led (usual care) with PN-led care of chronic disease in general practice. As reported elsewhere, this research took place in three general practices. 12–14 . Two of the practices were located in Queensland, one in a regional and the other in a metropolitan area. The other practice was located in a rural area of Victoria. One practice had a solo GP, while the other two practices had four GPs each. Each practice employed two to four PNs full time and/or part time. The model of care trialled in the main study 12 involved the PN leading the management of the patients’ care by following comprehensive clinical protocols, which were used in conjunction with an individually tailored general practice management plan (GPMP). The PNs were current registered nursing staff I