In a large cohort of adult patients with diabetes, no clinically significant variation was found among those managed by physicians, nurse practitioners (NPs), or physician assistants (PAs) regarding diabetes outcomes. 368,481 adult patients from 568 VA primary care facilities and treated pharmaceutically were included and potential differences in intermediate diabetes outcomes were measured among the 3 primary care providers (PCP) types. Among the findings:
- The PCPs were physicians (n=3,487), NPs (n=1,445), and PAs (n=443) for 74.9%, 18.2%, and 6.9% of patients, respectively.
- The difference in HbA1c values compared with physicians was ‒0.05% for NPs and 0.01% for PAs.
- For systolic blood pressure (SBP), the difference was ‒0.08 mm Hg for NPs and 0.02 mm Hg for PAs.
- For low-density lipoprotein cholesterol (LDL-C), the difference was 0.01 mmol/L for NPs and 0.03 mmol/L for PAs.
Jackson GL, Smith VA, Edelman D, et al. Intermediate diabetes outcomes in patients managed by physicians, nurse practitioners, or physician assistants: A cohort study. [Published online ahead of print November 20, 2018]. Ann Intern Med. doi:10.7326/M17-1987.
This Week's Must Reads
Intensive BP Control & Risk of Dementia, JAMA; ePub 2019 Jan 28; SPRINT MIND Investigators
Outpatient Care for Adults With Primary Care, JAMA Intern Med; ePub 2019 Jan 28; Levine, et al
Antibiotic Therapy in Patients with Asthma, JAMA Intern Med; ePub 2019 Jan 28; Stefan, et al
Outpatient Benzodiazepine Prescribing in US, JAMA Netw Open; 2019 Jan 25; Agarwal, et al
Reduction of Readmissions Through Primary Care, JAMA Netw Open; 2019 Jan 25; Wiest, et al
Must Reads in Diabetes
Hospitalization Rates in Young-Onset Diabetes, Ann Intern Med; ePub 2019 Jan 15; Ke, Lau, et al
Long-Term Absolute Risk for CVD by FG Level, Diabetes Care; ePub 2019 Jan 7; Bancks, et al
Prediabetes Status & Lifestyle Modification , J Am Board Fam Med; 2019 Jan 4; Owei, et al
Second-Line ADMs & CV Events in T2D, JAMA Netw Open; ePub 2018 Dec 21; O’Brien, et al
Rotating Night Shift Work & Risk of T2D, BMJ; ePub 2018 Nov 21; Shan, Li, et al