Primary Care Nursing Strategies For Diabetes, Hypertension, And Multi-Morbidity Management
VOLUME 21, 2024
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Nehal Abdulrahman Koshak, Manal Rashad Khaymi, Hanan Mohammed Alawal Alhwsawi, Yara Ameen Najmaldeen, Khalied Mohammed Noor Jamal
Amina Mohammed Bakhit Alluqmani, Sumaia Mohammed Ali Fallatah, Bassam Ayed Abdulrahman Almutairi, Zaher Saud Dabhan Almutairi, Basem Ayed Abdulrahman Almutairi
Abstract
Diabetes mellitus and hypertension are among the most prevalent chronic conditions managed in primary care and frequently coexist within complex multimorbidity profiles. Nurses in primary care play a pivotal role in chronic disease prevention, early detection, treatment optimization, patient education, and long-term follow-up. As healthcare systems confront aging populations, rising noncommunicable disease prevalence, and widening health inequities, nurse-led strategies have emerged as essential components of effective chronic disease management. This comprehensive narrative review examines evidence-based nursing strategies for the management of diabetes, hypertension, and multimorbidity in primary care settings. Emphasis is placed on clinical monitoring, patient education, lifestyle counseling, medication adherence support, care coordination, and integration of social determinants of health. The review highlights how primary care nursing practice functions as a cornerstone of population health and public health–oriented chronic disease control.
Keywords :
Primary care nursing; diabetes management; hypertension; multimorbidity; chronic disease management; noncommunicable diseases; patient-centered care.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty