Diabetes Care Processes and Outcomes in Patients Treated by Nurse Practitioners or Physicians
Abstract
PURPOSE the purpose of this study was to compare selected diabetes care processes and outcomes of nurse practitioners (NPs) and physicians (MDs) in the primary care of adults with type 2 diabetes. METHODS Adults with type 2 diabetes and no regular source of primary care were enrolled from the emergency room and randomized to an NP or MD practice. Chart reviews were conducted to assess processes of care; patient interviews and hemoglobin Al C (Al C) testing were performed to measure patient outcomes. RESULTS NPs were more likely than MDs to document provision of general diabetes education and education about nutrition, weight, exercise, and medications. They were more likely to document patient height, urinalyses results, and Al C values. No differences were found in documenting current medications; alcohol, illicit drug, or tobacco use; depression; weight and blood pressure; foot and cardiovascular exams; blood glucose and creatinine testing; or referral to ophthalmologists. No differences were found in patient outcomes. CONCLUSIONS This study provides preliminary evidence of interdisciplinary differences in the processes of care employed by primary care NPs and MDs in caring for patients with type 2 diabetes. NPs documented the provision of diabetes education and selected monitoring tests more frequently than MDs; however, these differences were not reflected in 6-month patient outcomes.
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Nurse practitioners have been reported to be more likely to follow guidelines and document care.
“Nurse practitioners have been reported to be more likely to follow guidelines and document care [37, 38].”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [38]
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- Authors
- Lenz, E. R., Mundinger, M. O., Hopkins, S. C., Lin, S. X., & Smolowitz, J. L.
- Affiliations
- The Ohio State University (US)
- Columbia University (US)
- Corresponding author
- Mundinger, Mary O'Neil
- Venue
- The Diabetes Educator
- Publisher
- SAGE Publications
- Published
- 2002-07
- Volume
- 28
- Issue
- 4
- Pages
- 590-598
- ISSN
- 0145-7217 (ISSN-L)
- 1554-6063
- OpenAlex
- W1973817910
- Cited by
- 80
- References
- 23
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 8 · 2012: 7
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Science of Diabetes Self-Management and Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- type 2 diabetes, nurse practitioners, physician care, primary care, glycemic control, HbA1c, diabetes education, health care documentation, patient outcomes, interdisciplinary comparison
- MeSH terms
- Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Male, Medical Audit, Medical History Taking, Middle Aged, New York, Nurse Practitioners, Nursing Assessment, Nursing Audit, Outcome and Process Assessment, Health Care, Patient Education as Topic, Physicians, Family, Primary Health Care, Nursing Evaluation Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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