AN EVALUATION OF A NURSE-LED EAR CARE SERVICE IN PRIMARY-CARE - BENEFITS AND COSTS

Background. Nurses trained in ear care provide a new model for the pro vision of services in general practice, with the aim of cost-effective treatment of minor ear and hearing problems that affect well-being an d quality of life. Aim. To compare a prospective observational cohort study measuring health outcomes and resource use for patients with ear or hearing problems treated by nurses trained in ear care with simila r patients treated by standard practice. Method. A total of 438 Rother ham and 196 Barnsley patients aged 16 years or over received two self- completion questionnaires: questionnaire 1 (Q1) on the day of consulta tion and questionnaire 2 (Q2) after three weeks. Primary measured outc omes were changes in discomfort and pain; secondary outcomes included the effect on normal life, health status, patient satisfaction, and re sources used. Results. After adjusting for differences at Q1, by Q2 th ere was no statistical evidence of a difference in discomfort and pain reduction, or differential change in health status between areas. Sat isfaction with treatment was significantly higher (P = 0.0001) in Roth erham (91%) than in Barnsley (82%). Average total general practitioner (GP) consultations were lower in Rotherham at 0.4 per patient with an average cost of pound 6.28 compared with Barnsley at 1.4 per patient and an average cost of pound 22.53 (P = 0.04). Barnsley GPs prescribed more drugs per case (6% of total costs compared with 1.5%) and used m ore systemic antibiotics (P = 0.001). Conclusions. Nurses trained in e ar care reduce costs, GP workload, and the use of systemic antibiotics , while increasing patient satisfaction with care. With understanding and support from GPs, such nurses are an example of how expanded nursi ng roles bring benefits to general practice. Nurses trained in ear car e reduce treatment costs, reduce the use of antibiotics, educate patie nts in ear care, increase patient satisfaction, and raise ear awarenes s.