title: To what extent do primary care practice nurses act as case managers lifestyle counselling regarding weight management? A systematic review.
abstract: BACKGROUND
  In this review study, we are the first to explore whether the practice nurse (PN) can act as case manager lifestyle counselling regarding weight management in primary care.
  
  
  METHODS
  Multiple electronic databases (MEDLINE, PsycINFO) were searched to identify relevant literature after 1995. Forty-five studies fulfilled the inclusion criteria. In addition, all studies were judged on ten quality criteria by two independent reviewers.
  
  
  RESULTS
  Especially in the last three years, many studies have been published. The majority of the studies were positive about PNs' actual role in primary care. However, several studies dealt with competency issues, including disagreement on respective roles. Thirteen studies were perceived as high quality. Only few studies had a representative sample. PNs' role in chronic disease management is spreading increasingly into lifestyle counselling. Although PNs have more time to provide lifestyle counselling than general practitioners (GPs), lack of time still remains a barrier. In some countries, PNs were rather ambiguous about their role, and they did not agree with GPs on this.
  
  
  CONCLUSIONS
  The PN can play the role of case manager lifestyle counselling regarding weight management in primary care in the UK, and wherever PNs are working under supervision of a GP and a primary health care team is already developed with agreement on roles. In countries in which a primary health care team is still in development and there is no agreement on respective roles, such as the USA, it is still the question whether the PN can play the case manager role.
authors.affiliation: Strategic Communication, Section Communication, Philosophy and Technology, Centre for Integrative Development (CPT-CID), Wageningen University, P.O. Box 8130, 6700 EW, Wageningen, the Netherlands. sonja.vandillen@wur.nl.
authors.forename: Sonja M E
authors.initials: SM
authors.lastname: van Dillen
authors.affiliation: Strategic Communication, Section Communication, Philosophy and Technology, Centre for Integrative Development (CPT-CID), Wageningen University, P.O. Box 8130, 6700 EW, Wageningen, the Netherlands. gertjanhiddink@wur.nl.
authors.forename: Gerrit J
authors.initials: GJ
authors.lastname: Hiddink
mesh_terms: D019090:Case Management; D003376:Counseling; D006801:Humans; D009722:Nurse Practitioners; D024802:Nurse's Role; D009765:Obesity / Q000451:nursing*; D059017:Primary Care Nursing; D040242:Risk Reduction Behavior; D061217:Weight Reduction Programs