From the Guidelines
Nurse practitioners generally provide care that is comparable to physicians in terms of patient outcomes, with some studies suggesting they may even achieve better results in certain areas such as patient education and preventive care. When examining the differences in patient outcomes with nurse practitioners, it's essential to consider the evidence from recent studies. According to a 2023 review of person-centered models for cardiovascular care by the American Heart Association 1, nurse-led models have shown promise in optimizing self-care capacity and resource availability for patients. The review highlights that advanced practice nurses (APNs) play a crucial role in ensuring communication and longer-term adherence to guideline-directed medical therapy (GDMT).
Some key findings from the review include:
- Practices with ≥2 APNs were more likely to use guideline-directed implantable cardioverter defibrillator/cardiac resynchronization therapy and provide heart failure education compared to practices without APNs 1.
- APNs were more likely to provide smoking cessation counseling and referral to cardiac rehabilitation compared to cardiologists 1.
- In the primary care setting, APNs were more likely to achieve glycemic control and adequate blood pressure control, whereas physicians were more likely to achieve lipid control and prescribe β-blockers after myocardial infarction 1.
- Nurse-led programs have demonstrated similar benefits in medication management and risk factor control to prevent stroke, and in some cases, have been found to be superior to usual care by a cardiologist for certain outcomes, such as cardiovascular death or hospitalization in patients with atrial fibrillation 1.
These findings suggest that nurse practitioners can provide high-quality care that is comparable to, or in some cases, superior to physician-led care, particularly in areas such as patient education, preventive care, and chronic disease management. The use of nurse practitioners in these settings can help address physician shortages while maintaining quality care, and their holistic training and emphasis on patient education and preventive care can lead to better health outcomes and patient satisfaction.
From the Research
Patient Outcomes with Nurse Practitioners
- Studies have shown that nurse practitioners (NPs) provide equal or better quality of care compared to their physician colleagues in primary care settings 2, 3, 4.
- A systematic review of 11 articles found that NPs provide equal or better quality of care for all outcomes when compared with their physician colleagues 2.
- Another study found that NPs in specialty settings perform as well as physicians in terms of clinical safety and positive patient outcomes 3.
- NPs have also been shown to match or exceed their physician counterparts in patient education and satisfaction 3.
Comparison of Quality of Care
- A study comparing the quality of care between NPs and physicians in outpatient specialty care settings found that NPs perform as well as physicians in terms of clinical safety and positive patient outcomes 3.
- Another study found that NPs provide access to effective primary care in a variety of settings, equal in quality outcomes, safety, and cost-effectiveness compared with physicians 4.
- A retrospective cohort study found that adults with diabetes received comparable quality of care from NPs and physicians at similar cost, while costs of NP-led care were lower for children with asthma but quality findings were mixed 5.
Practice Patterns and Quality of Care
- A study comparing the practice patterns and quality of care of NPs, physician assistants (PAs), and primary care physicians (PCMDs) in health centers found that NP and PA care were largely comparable to PCMD care 6.
- The study found that visits to NPs were more likely to receive recommended smoking cessation counseling and more health education/counseling services than visits to PCMDs 6.
- Visits to PAs also received more health education/counseling services than visits to PCMDs 6.