Patients with cardiovascular disease (CVD) receive comparable primary care when treated by physicians or non-physicians, yet there's room for both types of clinicians to improve respectively and in teams, according to new research published in Circulation: Cardiovascular Quality and Outcomes.
For the study, researchers reviewed data on performance measures, including blood-pressure monitoring, cholesterol monitoring and use of a beta-blocker, from more than 1.1 million CVD patients who made a primary care visit to one of 130 Veterans Affairs (VA) facilities from October 2013 to September 2014. The results showed that only 54.8 percent of those who received care from non-physicians, such as nurse practitioners (NPs) and physician assistants (PAs), and 54 percent who received care from doctors underwent all three performance measures.
"However, in terms of who was attending patients, we saw only small differences in the quality of care here and there, and the differences were not statistically significant," study lead author Salim Virani, M.D., Ph.D., an investigator with the VA Medical Center in Houston, told HealthDay.
For example, patients in the nonphysician groups were more likely to have their blood pressure under control, while physician-treated patients had lower LDL cholesterol and were more likely to receive a beta-blocker following a heart attack.
While the findings support the notion that NPs and PAs can help the U.S. primary care system overcome a shortage of doctors, teamwork remains an important goal. "I think in the future, a model with physicians and non-physicians working together will be good, especially for patients with a lot of chronic disease that will require management," Virani told Medscape.
Finally, researchers noted that this review did not evaluate whether physicians or non-physicians used more resources to achieve their results, which will be a subject of further study.