Are nurse-Led Patient consultations and nurse-led dose adjustments of permanent medication acceptable for the general population in Germany? Results from a population-based study (RESIDENCE Study)

Solveig Weise, Celina Wiens, Rafael Mikolajczyk, Thomas Frese, Felix Bauch

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

Background:

Practice nurse (PN)-led patient consultations and dose adjustments of permanent medication (pmed) are uncommon and understudied in general practice settings in Germany. Today, patient consultation and dose-adjustments of pmed are predominantly provided by general practitioners (GPs) in Germany, but current challenges in general practice make it necessary to study doctor nurse substitution.

Research questions:

What are the attitudes of the general population towards PN-led patient consultations and PN-led dose adjustments of pmed in general practice in Germany?

Method:

This is a cross-sectional survey of participants of the HeReCa cohort (Health Related Beliefs and Health Care Experiences). The HeReCa cohort is an online panel including persons aged 18 years and older in five federal regions in Germany. The HeReCa cohort regularly assess the general public's view on health issues. We used a self-developed and pre-tested questionnaire including items on attitudes towards PN-led patient consultations and PN-led dose adjustments of pmed, specific reasons for encounter or medication for PN-led consultations and PN-led dose adjustments. In addition, our questionnaire focuses on the preferences of the general adult population for general conditions for implementing PN-led care and sociodemographic variables. The survey was set up using LimeSurvey, starting in July 2023 and first results will be expected in September 2023. For statistical analyses we will use IBM SPSS 25 software.

Results:

We expect to present initial results at EGPRN meeting. Our data will show how many participants are open or reluctant to the concept of PN-led consultations and PN-led dose changes of pmed and for which reason for encounters they would accept PN-led care. We also expect to show which participants characteristics are associated with openness for PN-led consultations or PN-led dose adjustments of pmed.

Conclusions:

We expect that the results will be helpful for future pilot studies and additionally highlight relevant factors to consider when implementing doctor-nurse-substitution.

Points for discussion:

How would you set up a model project/pilot study starting from these data?

Has anyone in the audience had experiences with implementing a model project or a pilot study of doctor-nurse substitution in a country that does not do this habitually?

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