Keywords: delegation; doctor-nurse-substitution; nurse-led-care; patient consultation; interprofessional team care

Background:

Delegating tasks from general practitioners (GP) to practice nurses (PN) may address challenges in general practice. While studies show high acceptance, most data come from established countries, limiting transferability to Germany, with lacking quantitative data.

Aim of the study:

To examine general population’s attitudes toward PN-led consultations, focusing on willingness, condition-specific preferences, and influencing factors.

Methodology:

A cross-sectional, population-based online survey was conducted in the HeReCa-study panel, with participants randomly selected from five German states based on urbanity and age distribution. Data were collected (July–September 2023) via a pretested questionnaire. The survey was completed by 1,475 out of 1,532 respondents with a personal GP. Analysis included descriptive statistics, bivariate and multivariable logistic regression, and imputation of missing data (IBM SPSS 25.0, Stata 13.0).

Results:

The response was 49.97% (1,532/3,066). Approximately 39,3% of the study population receives treatment at a single practice. PN-led consultations were previously experienced by 3.8% of participants, while 83.6% of the remaining 1,419 expressed willingness to accept them. Acceptance was high for consultations on superficial wounds, and care of diabetes, hypertension, asthma, and respiratory infections. Multivariable regression indicated greater willingness among participants with higher trust in PNs’ professional (OR 2.03; 95%CI 1.35;3.06, reference: lower trust) and communication skills (OR 1.76; 95%CI 1.15-2.67). Older age (OR 0.73; CI 0.97-0.99, effect per standard deviation = 13.94 years) and treatment in single practices (OR 0.67; 95%CI 0.47-0.96, reference: group practices) were associated with lower acceptance . Gender and residency did not reach a statistically significant level in our analysis.

Conclusions:

We found a high willingness to accept PN-led consultations in the general population. Our findings provide valuable guidance for countries, where, like Germany, PN-led consultations have not yet been implemented. Future pilot projects on PN-led patient consultation should also consider our findings on factors of lower or higher acceptancefor PN-led care.