Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Cardiac patients receive as good care from ANPs as medics

  • 3 Comments

Patients with coronary artery disease, heart failure, and atrial fibrillation receive comparable outpatient care from doctors and nurse practitioners, according to a US study.

The authors of the study suggest their findings support the increasing use of integrated primary care models, with a mix of healthcare professionals, as a way of overcoming staff shortages.

“It should be reassuring that the quality of care for uncomplicated outpatient CVD is at least equivalent between advanced practice providers and physicians”

Salim Virani

They set out to compare care provided by primary care doctors with that received from advanced nurse practitioners and physician assistants – a type of clinical support role well established in the US but new to the UK, where they are more commonly known as physician associates.

The researchers assessed records from 648,909 patients receiving care in 90 general practices during 2012.

They compared quality of care among patients being treated by physician assistants and nurse practitioners, with those being treated in physician-only practices.

They looked at use of beta-blockers in patients with a history of heart attack, antiplatelet use, smoking screening and interventions to encourage smokers to quit, effective cholesterol control, referral to cardiac rehabilitation, and use of anticoagulation in patients with atrial fibrillation.

After adjusting for a range of factors, the researchers found that compliance with performance measures for coronary artery disease, heart failure, and atrial fibrillation were comparable across all practice types and clinicians.

The study found a higher rate of screening for smoking and interventions to encourage smokers to quit as well as a higher rate of referral to cardiac rehabilitation among advanced practice providers than among doctors.

“A collaborative care delivery model which employs both physicians and advanced practice providers appears to provide a care quality that is comparable to a physician-only model,” said lead study author Dr Salim Virani, from the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

“Our results also have healthcare policy implications,” he said. “It should be reassuring that the quality of care for uncomplicated outpatient cardiovascular disease is at least equivalent between advanced practice providers and physicians.”

The findings were published this month in the Journal of the American College of Cardiology.

  • 3 Comments

Readers' comments (3)

  • michael stone

    ' ... It should be reassuring that the quality of care for uncomplicated outpatient cardiovascular disease ...'

    That is the point, surely - in 'uncomplicated known disease', the strongest factor is intuitively likely to be 'day-to-day involvement with such patients, leading to familiarity with the illness'.

    Surely one of the major differences between doctors and nurses - which I consider to be diagnosis - isn't very significant, with the qualification 'uncomplicated known disease', and familiarity becomes the most important factor ?

    Rather like, if you are having a hip replaced, you don't want the world's best 'general surgeon' - you want a surgeon who does several hip replacements a week (something I think a research study proved to be the case) and who has got a lot of experience replacing hips.

    Unsuitable or offensive? Report this comment

  • Please stop using this picture of a nurse taking blood-ANPs do not really do this any more as we have fantastic HCAs to do it!!

    Unsuitable or offensive? Report this comment

  • Laha78

    Well said Kirsty!

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.