Using a collaborative care delivery model with both physicians and advanced practice providers “may deliver an overall comparable quality of outpatient cardiovascular care compared with a physician-only model,” according to a study published Oct. 12 in the Journal of the American College of Cardiology (JACC).   

Using data from the ACC’s PINNACLE Registry, Salim S. Virani, MD, PhD, FACC, et al., assessed records from 459,669 patients who were treated by 883 providers in 41 practices. Results showed that compliance with most coronary artery disease, heart failure and atrial fibrillation measures was comparable across all provider type. However, there was a higher rate of smoking cessation screening and intervention and cardiac rehabilitation referral among coronary artery disease patients receiving care from advanced practice providers than among physicians. Compliance with all eligible coronary artery disease measures, however, was low among both groups: 12.1 percent for advanced practice providers and 12.2 percent for physicians. 

“I am uncertain that these findings can be generalized across the varied health systems of the U.S.,” said Valentin Fuster, MD, PhD, MACC, editor-in-chief of JACC. “However, I am certain that team-based delivery models will provide the basis of the highest quality care.”

In an accompanying editorial, Robert A. Harrington, MD, FACC, notes that “team-based cardiovascular care, delivered in collaborative models with a diverse group of health care professionals all working at the top of their education and training, can offer the U.S. expanded access to high-quality, evidence-based care.” He adds that, “the cardiovascular community can serve as a model for health policymakers, who must be obliged to incorporate strong evidence into the deliberations and decisions that ultimately govern medical practice.”

Keywords: Atrial Fibrillation, Coronary Artery Disease, Coronary Disease, Heart Failure, Outpatients, Patient Compliance, Referral and Consultation, Smoking Cessation, National Cardiovascular Data Registries, PINNACLE Registry

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