Nurse practitioners and physician assistants were more likely than physicians to provide health education to patients with chronic conditions, though none of the practitioners offered such education on a regular basis, according to a study by the Centers for Disease Control and Prevention, published in April.
The CDC study examined five years of data (2005-2009) from the outpatient department of the National Hospital Ambulatory Medical Care Survey, looking at adult patient visits for chronic conditions, including asthma, COPD, depression, diabetes, hypertension and obesity.
The percentage of visits in which providers counseled patients on their condition ranged from 13% for patients with COPD or asthma who received information on tobacco use and exposure from nurse practitioners to 42.2% for patients with diabetes or obesity who received counseling on exercise from physician assistants. Rates of health education were higher among nurse practitioners and physician assistants than among physicians for all conditions, though the reasons for this were unclear, according to the report.
One potential explanation is that training programs for physician assistants and nurse practitioners may emphasize the provision of health education to patients more than training programs for physicians, according to the report. Other possibilities are that physicians may delegate the provision of health education to non-physician providers in a follow-up visit, or that patients may feel more comfortable requesting health information from nurse practitioners or physician assistants.
Nurse practitioners and physician assistants were more likely to document health education they provided in five of six areas, according to the report. Nurse practitioners were more likely to offer counseling on diet or nutrition and stress management than either physicians or physician assistants. Physician assistants were more likely to provide education on tobacco use and exposure for patients with COPD and asthma than either of the other two types of clinicians. Nurse practitioners and physician assistants were more likely to provide counseling on exercise and weight reduction than physicians. In three cases where physician assistants and nurse practitioners were less likely than physicians to provide health education, the differences were not significant, according to the report.