Transferability of nurse-led interventions for cardiovascular health across diverse nursing roles in primary and community settings: Practice implications and solutions from a scoping review.

Background: Although nurse-led interventions are increasingly recognised as effective in managing cardiovascular risk factors, a comprehensive synthesis is needed to support their widespread implementation across healthcare systems. Objective: This scoping review aimed to synthesise evidence to answer key questions: 1) Why do some nurse-led care models in primary and community settings succeed while others do not? 2) Which specific components of nurse-led interventions impact clinical outcomes? 3) What concerns exist about transferring these interventions to real-world settings, and what are potential solutions? Methods: We used the Arksey and O'Malley framework to review and synthesise literature from PubMed, Embase, and Web of Science, focusing on nursing, cardiovascular disease management, and primary care. We included 103 studies, using both quantitative and qualitative methods. Our analysis summarised research on the feasibility, effectiveness, health outcomes, costs, and cost-effectiveness of nurse-led interventions. A thematic analysis explored factors influencing their success, failure, and implementation. Results: Across 103 studies, a diverse group of nurses, including Nurse Practitioners, Practice Nurses, and Enrolled Nurses, implemented nurse-led interventions, with about a third (n=35) conducted in Europe. Nearly half of these studies reported reductions in blood pressure and improved medication adherence; some also observed decreases in lipid levels, enhanced quality of life, and lower blood glucose, weight, or BMI. A few studies reported fewer hospital admissions, though these findings should be interpreted with caution. Additionally, some research suggested that these services often cost the same or less than physician-led care. The effectiveness of nurse-led interventions depends on factors such as clinical governance, implementation capacity, quality of care, patient engagement, and outcome assessment. Conclusion: Nurse-led interventions by diverse groups of nurses can improve cardiovascular outcomes. However, evidence on their cost-effectiveness compared with physician-led care is limited to a few studies. Effectiveness depends on governance, capacity, quality, and engagement. More research is needed on their feasibility, adaptability, and cost across diverse populations.