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Table 1 Summary characteristics of participants and interventions of studies included in review

From: Substitution of physicians by nurses in primary care: a systematic review and meta-analysis

Study Setting Participants Nurses’ group Physicians’ group Intervention Outcomes reported
Location, first author, year Design, period* FUP, m Facilities, n Included diagnosis Nurses, n Patients, N Mean age (SD), y Male, % Phys., n Patients, N Mean age (SD), y Male, % Nurses’ training/experience FCA GDL PS QoL HA M C
ZA 2 cRCT, 2008-2010. 18 Nurse ART clinic, 31. HIV/AIDS. 103 6415 38 (8.9) 30 nr 6479 38 (9.63) 27 Middle nurse managers trained to assume responsibility for ART and established patients’ eligibility for ART. no yes     
Fairall, 2012 [36], cohort 2
ZA 1 cRCT, 2008-2010. 16-18 Nurse ART clinic, 31. HIV/AIDS. 103 6159 36 (9.6) 33 nr 4923 35 (9.63) 31 Middle nurse managers trained to assume responsibility for ART and established patients’ eligibility for ART. no yes     
Fairall, 2012 [36], cohort 1
NL 6 RCT, period nr. 14 Practice, 1. Diabetes Mellitus Type II. 2 116 67.1 (11) 53 5 114 69.5 (10.6) 42 Practice nurse with one week training in diabetes mellitus; nurse had no special training in the treatment of diabetes prior to starting trial. yes yes    
Houweling, 2011 [30]
NL 5 RCT, 2006-2008. 24 Hospital outpatients, 1; Practice, 18. Asthma. nr 36 11.2 (2.9) 64 nr 71 (37§, 34) 11.2 (2.5) §; 10.1 (2.6) 58 Asthma nurse. no yes     
Kuethe, 2011 [25]
RU 1 RCT, 2006 -2009. 6, 18 Medical centre practice, 1. Heart Failure with Preserved Ejection Fracture. 10 50 66.5 (3.2) 27 8 50 68 (4.3) 34 Nurses with special degree in patient education obtained in a joint course. no yes    
Andryukhin, 2010 [46]
NL 4 RCT, 2006-2007. 12 Healthcare centre, 6. CVD, Hypertension, Hypercholesterolemia. 6 808 64 (9.0) 58 25 818 64 (9.0) 62 Advance practice nurse already employed to manage patients with asthma, chronic obstructive pulmonary disease, or diabetes. nr yes      
Voogdt-Pruis, 2010 [16]
NL 3 RCT, 2006. 0.5 Practice, 15; Reference, 5 Common complaints. 12 817 42.8 (16.5) 38 50/17 684 46.1 (16.6) 40 Nurse practitioner with Master degree in Advance Nursing trained in common complaints. no yes   
Dierick-Van Dale, 2009 [39]
UK 9 RCT, 2002-2004. 6 Nurse clinic, 1 GORD, moderate Gastritis. nr 89 50.2 (13.9) 49 nr 86 48.4 (12.8) 49 Gastrointestinal nurse practitioner. no yes     
Chan, 2009 [42]
NL 2 cRCT, period nr. 12 nr. All forms of incontinence. 1 38 51 (13.0) 0 28 13 51 (13.0) 0 Registered nurse specialist in incontinence. no yes    
Du Moulin, 2007 [37]
US 6 RCT, period nr. 6 Community, 2; PHD, 1. Diabetes Mellitus. nr 95 55.7 (13.1) 32 108# 102 57 (11.4) 35 Diabetes nurse. no yes      
Hiss, 2007 [32]
NL 1 RCT, 2000-2001. 24 Practice, 12 Asthma and COPD. 2 139 49.9 (14.2) 35 14 137 44.7 (13.6) 28 GP assistant with pre- and during-trial training to deal with the differences between asthma and COPD. no yes      
Hesselink, 2004 [33]
UK 8 RCT, 2000-2001. 6 Nurse clinic hospital based. Diabetes Mellitus Type II pre-diagnosed with Hypertension or in receipt of BPLT. nr 60 58.1 (13.8) 57 nr 60 62.4 (9.1) 70 Hypertension nurse. no yes      
Denver, 2003 [40]
UK 7 RCT, 1996-1999. 24 Practice, 438. Parkinson's Disease. 9 1041 nr 57 nr 818 nr 56 Community nurse with a course in Parkinson Disease. no nr    
Jarman, 2002 [29]
UK 6 RCT, period nr. 4 Health Centre Practice, 1 Asthma nr 55 Median (IQR): 35 (29-47) 56 9 46 Median (IQR): 37 (27-50) 33 Nurse with structured training in Asthma care. no yes      
Kernick, 2002 [27]
US 5 RCT, 1995-1997. 6-12, 24 Community clinic, 4; Primary care clinic, 1. Asthma, Diabetes Mellitus, Hypertension, or urgent visits. 7 1181 44 24 11 800 44.9 22 Community nurse practitioner. no nr   
Mundinger, 2000 [22, 24]
UK 5 Kernick, 2000 [28] RCT, period nr. 4 Health Centre, 1 Psoriasis and Eczema. 1 55 47.4 (18.4) 39 nr 54 51.7 (15.8) 48 Practice nurse with training in psoriasis and eczema management. no yes      
UK 4 RCT, period nr 0.5-1 Practice, 10 Diverse complaints. 12 1465 range: 0 to >75 39 10 1465 range: 0->75 42 Nurse practitioner with diploma on care for same day consultations for primary care. no nr     
Kinnersley, 2000 [26]
UK 3 RCT, period nr. 0.5 Practice, 20 Diverse complaints: e.g. minor injuries, respiratory complaints. 20 (1 per practice) 651 nr 42 nr 665 nr 43 Nurse with course at BSc or MSc level. no nr   
Venning, 2000 [17]
UK 2 RCT, 1998-1999. 0.5 Practice, 5 Acute minor illnesses. 5 900 median (IQR): 26 (9-41.8) 40 19 915 median (IQR): 29.1 (9.7-44.9) 40 Practice nurse with a course in minor illnesses and piloted before study. no nr     
Shum, 2000 [18]
US 4 qRCT, 1999-2001. 12 Primary care veterans affair clinic, 1 Undifferentiated conditions. 9 150 62 99 45 300 61 98 Nurse practitioner who was on staff for at least six months in primary care. yes yes     
Hemani, 1999 [34]
UK 1 RCT, 1995-1996. 12, 24, 56.4, 122.4 Practice, 19 Coronary Heart Disease secondary prevention. 28 673 66.1 (8.2) 58 nr 670 66.3 (8.2) 58 District and practice nurses trained in clinic protocols/GDLs for behavioural techniques change. no yes  
Campbell, 1998 [1921, 41, 4345]
US 3 RCT, 1980. 0.5 Community clinic, 1 Family planning, venereal diseases, acute non-traumatic minor illnesses. 5 25 nr nr 5 25 nr nr Registered professional nurse with preparation and skills in physical diagnosis, psychosocial assessment, and health-illness management in primary care. nr yes     
Winter, 1981 [15]
US 2 RCT, 1971. ≥6 HO clinic, 1; Private, 3 Undifferentiated. 4 40 nr nr nr 20 nr nr Nurse clinicians with training in service delivery. yes nr      
Flynn, 1974 [35]
US 1 RCT, period nr. 12 University Hospital clinic, 1; Nurse clinic, 1 Hypertension, CVD, Obesity, Arthritis, Somatization. nr 33 range: 16-78 12 nr 33 range: 16-83 12 Nurses who provided primary source care for at least one year before the study. no yes  
Lewis, 1967 [23]
  1. Legend.
  2. Studies are listed by year (y) of publication, in decreasing order; and labelled after the country where they were conducted.
  3. US, United States; NL, The Netherlands; UK, United Kingdom; ZA, South Africa; RU, Russia; RCT, Randomised Controlled Trial; cRCT, cluster Randomised Controlled Trial; qRCT, quasi-Randomised Controlled Trial; FUP, follow-up episodes are reported in months (m); nr, not reported; ART, Antiretroviral Therapy; PHD, public health department; HO, Hospital Outpatients; HIV, Human Immunodeficiency Virus; CVD, Cardiovascular Disease; GORD, Gastro-Oesophageal Reflux Disease; COPD, Chronic Obstructive Pulmonary Disease; BPLT, Blood Pressure Lowering Treatment; SD, standard deviation; IQR, Interquartile Ranges;
  4. FCA, full clinical autonomy; GDL, interventions based on clinical guidelines or protocols; PS, patient satisfaction; QoL, quality of life; HA, hospital admissions; M, mortality; C, costs.
  5. *Start and end year when studies were conducted.
  6. Reference practices for comparison on economic/cost data.
  7. Paediatricians.
  8. §General physicians.
  9. Number of randomized patients per group not reported.
  10. Nine were physicians and nineteen were supervisors.
  11. #Sixty-three were for the control group.