Are nurse-Led Patient consultations and nurse-led dose adjustments of permanent medication acceptable for the general practitioners and practice nurses in Germany? - Results from a survey in two federal states

Solveig Weise, Julia Morgner, Felix Bauch, Celina Wiens, Thomas Frese

Keywords: delegation; doctor-nurse-substitution; nurse-led care

Background:

Background: Practice nurse (PN)-led patient consultations (PN-led PC) and dose adjustments of permanent medication (DCPM) are uncommon and understudied in general practice offices (GPO) in Germany.

Research questions:

What are the attitudes of GPs and PNs towards PN-led PC and PN-led DCPM in GPO in Germany?

Method:

This is a cross-sectional survey of GPs and PNs in two federal German states, Saxony-Anhalt and Saxony. In Saxony-Anhalt, we contacted all registered GPs randomly either per post (printed questionnaire) or per email (online questionnaire via LimeSurvey), in Saxony, all registered GPs with available email data were invited. We asked GPs to invite their PNs in the study.
We used a self-developed, pre-tested questionnaire including items on attitudes towards PN-led PC and PN-led DCPM, specific reasons for encounter, sociodemographic variables and preferences for implementing PN-led care. For statistical analyses we use descriptive statistics and will use logistic regression analysis using IBM SPSS 25 software.

Results:

Data collection in Saxony is currently ongoing, we will present initial results. In Saxony-Anhalt 206 GPs and 123 PNs of 1444 contacted practices participated (14.3% response rate). Of those, 59.7% of GPs and 65.5.% of PNs were willing or rather willing to implement PN-led PC in GPO, whereas 33.5% of GPs and 29.3% of PNs were not or rather not willing. Concerning PN-led DCPM, 41.6% of GPs and 40.5% of PNs were willing or rather willing to implement this in GPO, whereas 57.4% of GPs and 51.0% of PNs were not willing or rather not willing. We expect to report which participants characteristics are associated with openness for PN-led care and what aspects they perceive as important in the implementation process of PN-led care.

Conclusions:

We expect that the results will be helpful for future pilot studies and additionally highlight relevant factors to consider when implementing extended task shifting.

Points for discussion:

How would you set up a model project/pilot study with the aim to implement PN-led care starting from these data?

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