Nurse Practitioner-Run Specialty
Clinic May Prove Effective in Type 2 Diabetes
Management
Nurse practitioner (NP) specialty clinics
for the management of patients with Type 2 diabetes
appear to be an effective way to ensure high quality
care of the growing number of people with the
disease.
That, according to a new study presented July
1st at the American Academy of Nurse Practitioners
annual meeting.
In a comparison of an NP-run specialty clinic
and an internal medicine (IM) resident-operated
clinic at a major university medical center, researchers
found that the level of care -- as measured by
the extent to which patients achieved glycemic
control -- provided by NPs was at least comparable
and in some aspects superior to that provided
by the IM residents.
The study, conducted by pharmacists at the University
of Mississippi Medical Center in Jackson, involved
a retrospective chart review of 42 diabetes patients
treated in the NP specialty clinic and 87 patients
treated by internal medicine residents. The mean
age of patients in the NP group was 49 years and
54 in the IM group.
All patients in the study had been treated for
at least 6 months and all had at least 3 clinic
visits. Patients were assessed for all factors
related to diabetes management and disease-associated
complications, including glycemic measures, blood
pressure, lipid control, aspirin therapy, dilated
retinal exams, microalbuminuria screening and
use of angiotensin-converting enzyme inhibitors.
Mean baseline hemoglobin A1c (HbA1c) was 10.1%
in the NP-managed patients and 8.6% in the IM
group.
Attainment of key goals set by the American Diabetes
Association, specifically HbA1c levels of less
than 7%, was similar in both groups (33.3% in
the NP group and 37.9% in the IM-resident group).
Patients in the NP group received a mean of 3.9
HbA1c tests, compared to 3.4 in the IM group.
Dilated retinal exams were documented in 33.3%
of the NP patients, versus 18.4% of IM patients.
Lead researcher Kristi Kelley, PharmD, noted
that while the study showed that NPs and IM residents
provided comparable levels of care to diabetes
patients, there is "considerable room for
improvement in this … population" regardless
of who is managing the patients.
[Study title: Management of Type 2 Diabetes:
Comparison of a NP Specialty Clinic & an Internal
Medicine Resident Clinic. Poster 1]
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