Nurses, PAs as good as doctors for HIV care
|
|
Nurse practitioners and physician assistants can care for HIV patients as well as doctors specializing in the disease—and may do a better job than non-specialist doctors, researchers reported Monday.
Their study, of 68 HIV clinics in the U.S., found that nurse practitioners and physician assistants offered a quality of care similar to that of doctors specializing in HIV/AIDS. And they generally outperformed generalist doctors in the eight quality-of-care measures the researchers considered.
Nurse practitioners (NPs) and physician assistants (PAs) go through education and training that allows them to diagnose and treat patients; while many provide primary care services, some specialize in managing certain diseases, including HIV/AIDS.
NPs and PAs have long been an important part of HIV care, but “almost nothing” had been known about how well they perform in the role of lead caregiver, said Dr. Ira B. Wilson of Tufts-New England Medical Center in Boston, the lead author of the new study.
The findings, he told Reuters Health, show they are doing good job.
There are, though, some “preconditions” to receiving high-quality HIV care from an NP or PA, Wilson and his colleagues note in a report in the Annals of Internal Medicine.
Namely, practitioners should specialize in treating HIV, have a good deal of practical experience and have easy access to a doctor with expertise in HIV. About half of patients in the study who primarily saw an NP or PA also visited a doctor at some point during the year.
Wilson and his colleagues based their findings on medical records for 6,651 patients treated at 68 government-funded HIV clinics across the U.S. The researchers focused on eight indicators of quality of care—such as the use of powerful HIV drug combinations known as HAART, and preventive services such as flu shots and screening for hepatitis C, tuberculosis and cervical cancer.
On most of these measures, the researchers found, NPs and PAs offered a quality of care similar to that of doctors specializing in HIV, and better than that of generalist doctors. On two quality measures, NPs and PAs even outperformed specialist physicians.
But Wilson cautioned against viewing the findings in terms of “who’s better,” particularly when it comes to a chronic, complex disease like HIV/AIDS, which is probably best managed by a team of healthcare providers.
“This is a message about training, expertise and teamwork,” he said.
The fact that NPs and PAs can provide high-quality HIV care, Wilson noted, is especially relevant to rural and inner-city areas in the U.S., where there are often doctor shortages—as well as to those developing nations hardest-hit by the AIDS epidemic.
SOURCE: Annals of Internal Medicine, November 15, 2005.
Print Version
Tell-a-Friend comments powered by Disqus
