Title : Thirty years of nurse-led cardiovascular disease management in Australia: A systematic review
Abstract:
Nurses play an important role in preventing and managing long-term cardiovascular disease. A systematic review was undertaken to synthesize the evidence from 30 years of cardiovascular nurse-led interventions in Australia. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized control trials published between 1995 – 2025, which provided complete data sets were eligible for inclusion. A combination of electronic databases including the Cochrane Library, CINAHL, PubMed, ClinicalTrials.gov and the Australia New Zealand Clinical Trials Registry were searched. In addition, targeted website search and backward citation searches were also applied. Data extraction was undertaken using a PICOS framework. Bias assessment was conducted via the Cochrane Risk of Bias 2 tool. A total of 21 studies (n=9815 participants, 54% male) were included. Most of the studies investigated secondary or tertiary prevention strategies, with only two studies addressing primary prevention. Included adult populations had heart failure, atrial fibrillation, stroke, metabolic syndrome, type 2 diabetes and at-risk cohorts. Studies that utilized nurse-led interventions reported higher numbers of days alive and out-of-hospital (3/3 studies), reduced hospital days (6–12 days) and cost reduction (up to 40%). Although metabolic improvements were noted (−9 kg, −0.63% HbA1c), with no notable changes in lifestyle behaviours or mortality rates. The lack of incorporation of nurse-led interventions into both primary prevention and rural settings indicate that earlier and more risk stratification-based approaches are needed, including social determinants of health components to optimize cardiovascular outcomes for adults in Australia.
