Impact of nurse practitioners in primary care on patients with chronic diseases in rural and underserved areas: A systematic review.
Ariane Sacchetti, Mélanie Berube, Christophe Pison et al.
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In 30 seconds
This systematic review assessed nurse practitioners’ (NPs’) roles in primary care for people with chronic diseases, with a focus on rural, remote, and underserved settings. It included 25 studies, of which 10 were randomised controlled trials; no meta-analysis was conducted. NPs may improve access to primary care and chronic disease management, and patient satisfaction was generally higher than with general practitioners (GPs). Clinical and biological outcomes were often comparable between NPs and GPs, while collaborative NP-GP models had the best reported results and were associated with higher costs.
Key findings
- The review included 25 studies, including 10 randomised controlled trials.
- NPs may improve access to primary care and chronic disease management, particularly in underserved areas.
- Patient satisfaction was generally higher with NPs, possibly reflecting longer consultations and more patient education.
- Clinical and biological outcomes were often comparable between NPs and GPs; collaborative models had the best results but higher costs.
Why it matters
Access to primary care is constrained in rural and underserved settings, and this review suggests NPs may contribute to chronic disease care without generally worse clinical or biological outcomes than GP care. The findings also indicate that collaboration may be valuable, while its reported higher costs are relevant when considering how services are organised.
What to keep in mind
The review found no basis for meta-analysis, and not all included studies directly compared NPs with traditional care models.