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Diabetes Care Superior with Nurse-Practitioners

Guideline adherence significantly higher compared to offices with physician's assistants

TUESDAY, Jan. 15 (HealthDay News) -- Among family practices, the quality of diabetes care is significantly higher in those that employ nurse-practitioners compared with offices employing physicians only or physician's assistants, according to study findings published in the January/February issue of the Annals of Family Medicine.

Pamela A. Ohman-Strickland, Ph.D., of the UMDNJ School of Public Health in Piscataway, N.J., and colleagues measured adherence to American Diabetes Association guidelines by conducting chart audits of 846 diabetics who received care at 46 practices in New Jersey and Pennsylvania, including nine practices with nurse-practitioners, nine with physician's assistants and 28 that were physician-only.

Compared to practices with physicians' assistants, the researchers found that practices with nurse-practitioners were more likely to measure hemoglobin A1c levels (66 percent versus 33 percent), lipid levels (80 percent versus 58 percent) and urinary microalbumin levels (32 percent versus 6 percent); and more likely to treat high lipid levels (77 percent versus 56 percent) and have patients attain lipid targets (54 percent versus 37 percent). The investigators also found that practices with nurse-practitioners were more likely than physician-only practices to measure hemoglobin A1c levels (66 percent versus 49 percent) and lipid levels (80 percent versus 68 percent).

"With the burgeoning use of physician's assistants and nurse-practitioners in attempts to cut costs and try different models of clinical care, these results point to a need for additional research to confirm these associations and to explore their causes," the authors conclude.

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