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Improved outcomes make the case for nurse-led primary care more compelling

Nurses ‘possibly even better’ than Doctors

Cochrane Database of Systematic Reviews (2018) DOI: 10.1002/14651858.CD001271.pub3.

For some conditions, trained nurses ‘probably provide equal or possibly even better quality of care compared to primary care doctors, and probably achieve equal or better health outcomes for patients,’ a Cochrane review concludes.

The reviewers examined 18 randomised studies that evaluated the impact of nurses substituting for doctors in primary care. Six studies were performed in the UK. The study periods ranged from 2 weeks to 48 months and considered first-contact, including urgent care, ongoing care for physical complaints, and follow-up of patients with certain chronic conditions, such as diabetes. The authors excluded mental health problems. In many studies, nurses could ask doctors for additional support or advice.

Health outcomes for ‘a broad range’ of conditions are similar or better when care is delivered by nurses rather than doctors. For instance, nurse-led primary care probably slightly improves blood pressure control. Other clinical or health status outcomes are probably similar. Although nurse-led primary care may result in slightly fewer deaths among some patients, the results vary and the authors comment that this important outcome needs further investigation.

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