Evidence map›Paper›PMID 19744350›Full record

ArticleAustralia and New Zealand health policy2009

What evidence is there to support skill mix changes between GPs, pharmacists and practice nurses in the care of elderly people living in the community?

Sarah Dennis, Jenny May, David Perkins, Nicholas Zwar, Bonnie Sibbald, Iqbal Hasan

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Australia and New Zealand health policy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  8. Delegating home visits in general practice: a realist review on the impact on GP workload and patient care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Sarah Dennis *Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
Jenny May *University Department of Rural Health (UDRH), University of Newcastle, Locked Bag 9783, New England Mail Sorting Centre, NSW, 2348, Australia.
David Perkins *Broken Hill University Department of Rural Health, University of Sydney, PO Box 457, Broken Hill, NSW, 2880, Australia.
Nicholas Zwar *School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
Bonnie Sibbald *National Primary Care Research and Development Centre (NPCRDC), University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
Iqbal Hasan *Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
UNSW Sydney · AUUniversity of Manchester · GBUniversity of Newcastle Australia · AUUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWorkforce shortages in Australia are occurring across a range of health disciplines but are most acute in general practice. Skill mix change such as task substitution is one solution to workforce shortages. The aim of this systematic review was to explore the evidence for the effectiveness of task substitution between GPs and pharmacists and GPs and nurses for the care of older people with chronic disease. Published, peer reviewed (black) and non-peer reviewed (grey) literature were included in the review if they met the inclusion criteria.

resultsForty-six articles were included in the review. Task substitution between pharmacists and GPs and nurses and GPs resulted in an improved process of care and patient outcomes, such as improved disease control. The interventions were either health promotion or disease management according to guidelines or use of protocols, or a mixture of both. The results of this review indicate that pharmacists and nurses can effectively provide disease management and/or health promotion for older people with chronic disease in primary care. While there were improvements in patient outcomes no reduction in health service use was evident.

conclusionWhen implementing skill mix changes such as task substitution it is important that the health professionals' roles are complementary otherwise they may simply duplicate the task performed by other health professionals. This has implications for the way in which multidisciplinary teams are organised in initiatives such as the GP Super Clinics.

Identifiers

PMID19744350
PMCPMC2749853
OpenAlexW2142623790

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.