Improved Availability and Quality of Care with Epilepsy Nurse Practitioners

In Neurology, Chloe Hill and colleagues, including Judy Shea and Nabila Dahodwala, investigate the quality of care delivered by nurse practitioner (NP)–physician teams developed to serve patients with epilepsy, and improve their appointment availability.  The authors observed a cohort of patients with epilepsy who were cared for by either an NP-physician team or a physician only. These care models were compared with regard to adherence to the 2014 American Academy of Neurology epilepsy quality measures. The authors also looked at seizure frequency, presentations to the Emergency Department, injury, and death rates over the subsequent year. They find that the NP-physician team care model saw, on average, three more patients per clinic session. The NP–physician team care model showed equivalent adherence to the physician-only care model for the epilepsy quality measures, with superior adherence to the counseling measures of querying for side effects, provision of personalized epilepsy safety education, and screening for behavioral health disorders. The two care models performed similarly in all clinical outcomes in the subsequent year of investigation. These results suggest that an NP-physician team care model employed to increase availability of care could also improve quality of care delivered.