title: A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care.
abstract: OBJECTIVE
  To compare the effectiveness of care delivered by nurses to the usual care delivered by general practitioners, in adult patients requesting same day appointments in primary care practices in Catalonia (Spain).
  
  
  BACKGROUND
  Same day appointments conducted by nurses are characterized by high patient satisfaction and a high resolution index. The profile of nursing and the organization of primary care services in our country differ from other countries.
  
  
  METHODS
  Multicentre, randomized, unblinded clinical trial with two parallel groups.
  
  
  METHODS
  Patients were randomized to an intervention group (seen by nurses trained to respond to low complexity problems) or a control group (seen by the general practitioner) using an automatic probabilistic function.
  
  
  METHODS
  38 primary care practices in Catalonia, 142 general practitioners and 155 nurses participated. Population study: ≥ 18-year-old patients who requested a same day consultation. Recruitment period: January-May, 2009. Of the 1,461 randomized patients, 92.5% completed the study.
  
  
  METHODS
  resolution of symptoms and patient satisfaction 2 weeks after the visit.
  
  
  RESULTS
  Seven hundred and fifty-three patients were assigned to the intervention group and 708 to the control group. Nurses successfully solved 86.3% of the cases. We did not observe any differences in resolution of symptoms or patient satisfaction between the groups.
  
  
  CONCLUSIONS
  Nurses trained specifically to resolve acute health problems of low complexity give comparable quality of care to that provided by general practitioners in terms of resolution of the problem 15 days after the visit and in patient satisfaction with the visit.
authors.affiliation: EAP Baix a Mar, Consorci de Serveis a les Persones, Vilanova i la Geltrú, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Iglesias
authors.forename: Francisca
authors.initials: F
authors.lastname: Ramos
authors.forename: Beatriz
authors.initials: B
authors.lastname: Serrano
authors.forename: Mireia
authors.initials: M
authors.lastname: Fàbregas
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez
authors.forename: María José
authors.initials: MJ
authors.lastname: García
authors.forename: Hèlia Marta
authors.initials: HM
authors.lastname: Cebrian
authors.forename: Rosa
authors.initials: R
authors.lastname: Aragonés
authors.forename: Josep
authors.initials: J
authors.lastname: Casajuana
authors.forename: Neus
authors.initials: N
authors.lastname: Esgueva
mesh_terms: D000208:Acute Disease / Q000451:nursing / Q000628:therapy*; D000328:Adult; D001071:Appointments and Schedules; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000592:standards*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration*; D013030:Spain; D055815:Young Adult
keywords: low complexity problems; nurses; patient satisfaction; primary care; resolution; same day consultation