Patients with diabetes who were treated by physician assistants (PAs) and nurse practitioners (NPs) had similar health outcomes as patients treated by physicians, according to a study published in the Journal of the American Academy of Physician Assistants.
Researchers used electronic health record data from the Veterans Health Administration to determine whether patients with diabetes treated by different types of primary care providers (PCPs) had different chronic illness outcomes. Patients received care from usual and supplemental provider types, which were grouped as follows.
- Physician only
- Physician PCP plus NP supplemental
- Physician PCP plus PA supplemental
- NP PCP plus physician supplemental
- PA PCP plus physician supplemental
- NP PCP no physician
- PA PCP no physician
A total of 609,668 patients with diabetes were included in the study (96.7% men; average age, 65.1 years). The majority of patients received care from physicians only (66.9%). NP PCPs with no physicians treated 10.8% of patients; PA PCPs with no physicians treated 4% of patients.
Levels of hemoglobin A1C, systolic blood pressure, and low-density lipoprotein cholesterol compared among patients treated by different primary care and supplemental groups did not reveal clinically significant differences, indicating that the quality of patient outcomes remained steady across each group.
“Redesigning primary care to meet the needs of patients with chronic illness is a focus for many healthcare organizations, and incorporating a range of clinicians, including physicians, NPs, and PAs, is a commonly proposed strategy,” the authors noted.
Reference Everett CM, Morgan P, Smith VA, et al. Are there differences in patients’ intermediate diabetes outcomes?JAAPA. 2019;32(6):36-42.