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Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting "same day" consultations in primary care
Open accessAbstract
OBJECTIVE: To ascertain any differences between care from nurse practitioners and that from general practitioners for patients seeking "same day" consultations in primary care. DESIGN: Randomised controlled trial with patients allocated by one of two randomisation schemes (by day or within day). SETTING: 10 general practices in south Wales and south west England. SUBJECTS: 1368 patients requesting same day consultations. MAIN OUTCOME MEASURES: Patient satisfaction, resolution of symptoms and concerns, care provided (prescriptions, investigations, referrals, recall, and length of consultation), information provided to patients, and patients' intentions for seeking care in the future. RESULTS: Generally patients consulting nurse practitioners were significantly more satisfied with their care, although for adults this difference was not observed in all practices. For children, the mean difference between general and nurse practitioner in percentage satisfaction score was -4.8 (95% confidence interval -6.8 to -2.8), and for adults the differences ranged from -8.8 (-13.6 to -3.9) to 3.8 (-3.3 to 10.8) across the practices. Resolution of symptoms and concerns did not differ between the two groups (odds ratio 1.2 (95% confidence interval 0.8 to 1.8) for symptoms and 1.03 (0.8 to 1.4) for concerns). The number of prescriptions issued, investigations ordered, referrals to secondary care, and reattendances were similar between the two groups. However, patients managed by nurse practitioners reported receiving significantly more information about their illnesses and, in all but one practice, their consultations were significantly longer. CONCLUSION: This study supports the wider acceptance of the role of nurse practitioners in providing care to patients requesting same day consultations.
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“Increased involvement of non-physicians such as Registered Nurses (RNs) and Nurse Practitioners (NPs) has long been recognized as an effective way to enhance access to primary care services.6-12”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [12]
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“Measurable clinical outcomes are systematically found to be equivalent11,18,19,23,27-32 to those produced by medical models, though patient satisfaction tends to be higher for nurse-provided services.11,19,21,26,27,29,30,33,34”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [30]
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Metadata
- Authors
- Kinnersley, P.
- Affiliations
- Cardiff University (GB)
- Corresponding author
- Kinnersley, P.
- ORCID
- Kinnersley, P.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2000-04-15
- Volume
- 320
- Issue
- 7241
- Pages
- 1043-1048
- ISSN
- 0959-8138 (ISSN-L)
- PMC
- PMC27347
- OpenAlex
- W2064193170
- Cited by
- 428
- References
- 17
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 10 · 2023: 4 · 2022: 3 · 2021: 15 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 10 · 2016: 15 · 2015: 20 · 2014: 21 · 2013: 24 · 2012: 13
- FWCI
- 62.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Office of Research and Development
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- nurse practitioners, general practitioners, primary care, patient satisfaction, symptom resolution, consultation time, patient information, children, adults, nurse practitioner role
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Child, Child, Preschool, England, Family Practice, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Nurse Practitioners, Patient Acceptance of Health Care, Time Factors, Wales, Patient Satisfaction, Patient Selection
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