Collaborative care - The role of practice nurses

Area of Science:

• Primary Care
• Chronic Disease Management
• Mental Health Integration

Background:

• Comorbid depression frequently co-occurs with chronic conditions like diabetes and heart disease.
• Integrating mental health screening into routine chronic disease care presents a significant challenge.
• Practice nurses are well-positioned to play a key role in managing these complex patient needs.

Purpose of the Study:

• To assess the feasibility of practice nurses detecting and monitoring depression in patients with diabetes and heart disease.
• To evaluate the acceptance and effectiveness of an expanded role for practice nurses in managing comorbid depression.

Main Methods:

• A feasibility study was conducted across six general practices in southeast Australia.
• Practice nurses received training on depression detection using the Patient Health Questionnaire.
• A convenience sample of 332 patients with diabetes and/or heart disease participated.

Main Results:

• Depression was identified in 34% of the participating patient sample.
• After 18 months, practice nurses strongly supported continuing the integrated care model.
• General practitioners rated the model highly for effectiveness and willingness to continue.

Conclusions:

• Practice nurses can successfully integrate depression monitoring into the systematic care of patients with diabetes and heart disease.
• The findings support the expanded role of practice nurses in managing comorbid depression within primary care settings.
• A randomized controlled trial is ongoing to compare this model with usual care for clinical outcomes.