Trial reportBMJ (Clinical research ed.)2004
Impact of nurse practitioners on workload of general practitioners: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Family Physician-Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review.Annals of family medicine · 2016Pooled it
- To what extent do primary care practice nurses act as case managers lifestyle counselling regarding weight management? A systematic review.BMC family practice · 2014Pooled it
- Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis.Ontario health technology assessment series · 2013Pooled it
- Barriers to implementation of case management for patients with dementia: a systematic mixed studies review.Annals of family medicinePooled it
- Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Trial
- Task shifting from general practitioners to nurses and the association with patient flow and resource use in out-of-hours primary care clinics: a descriptive register-based study.Scandinavian journal of primary health care · 2026Article
- Interprofessional teams and capacity in collaborative primary care: a rapid scoping review.Systematic reviews · 2026Article
- Interprofessional team-based primary care practice and preventive cancer screening: evidence from Family Health Teams in Ontario, Canada.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- The association between the workload of general practitioners and patient experiences with care: results of a cross-sectional study in 33 countries.Human resources for health · 2020Article
- Identification of barriers and facilitators in nationwide implementation of standardized structured reporting in pathology: a mixed method study.Virchows Archiv : an international journal of pathology · 2019Article
- Benefits of Advanced Practice Nursing for Its Expansion in the Spanish Context.International journal of environmental research and public health · 2019Review
- The workload for home visits by German family practitioners: an analysis of regional variation in a cross-sectional study.BMC family practice · 2019Article
- Pharmacists' perceptions of their emerging general practice roles in UK primary care: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Screening and Registering Patients with Asthma and Copd in Slovenian Primary Care: First Results.Zdravstveno varstvo · 2015Article
- Article
- Balancing risk prevention and health promotion: towards a harmonizing approach in care for older people in the community.Health care analysis : HCA : journal of health philosophy and policy · 2014Article
- The productivity and cost-efficiency of models for involving nurse practitioners in primary care: a perspective from queueing analysis.Health services research · 2012Article
- Challenges in physician supply planning: the case of Belgium.Human resources for health · 2010Article
- Primary care nurses: effects on secondary care referrals for diabetes.BMC health services research · 2010Article
- Change in UK government must not mean widespread removal of GPs.Journal of the Royal Society of Medicine · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the impact on general practitioners' workload of adding nurse practitioners to the general practice team.
designRandomised controlled trial with measurements before and after the introduction of nurse practitioners.
setting34 general practices in a southern region of the Netherlands.
participants48 general practitioners.
interventionFive nurses were randomly allocated to general practitioners to undertake specific elements of care according to agreed guidelines. The control group received no nurse.
main outcome measuresObjective workload, derived from 28 day diaries, included the number of contacts per day for each of three conditions (chronic obstructive pulmonary disease or asthma, dementia, cancer), by type of consultation (in practice, telephone, home visit), and by time of day (surgery hours, out of hours). Subjective workload was measured by using a validated questionnaire. Outcomes were measured six months before and 18 months after the intervention.
resultsThe number of contacts during surgery hours increased in the intervention group compared with the control group (P < 0.06), particularly for patients with chronic obstructive pulmonary disease or asthma (P < 0.01). The number of consultations out of hours declined slightly in the intervention group compared with the control group, but this difference did not reach significance. No significant changes became apparent in subjective workload.
conclusionAdding nurse practitioners to general practice teams did not reduce the workload of general practitioners, at least in the short term. This implies that nurse practitioners are used as supplements, rather than substitutes, for care given by general practitioners.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.