Treatment outcomes and patient satisfaction in cardiovascular disease – a clinical evaluation of primary care by nurse practitioners and physicians – a mixed-methods study
Cardiovascular patients
The research project follows an explanatory sequential mixed-method design (Creswell & Plano Clark, 2018). This means that quantitative data are collected first and subsequently deepened and explained through qualitative insights. Phase 1: Quantitative sub-study (RCT) A randomized controlled trial will be conducted over a period of 12 months. Patients with chronic cardiovascular diseases will be randomly assigned to one of two groups via software: Intervention group (NP model): Patients are primarily managed by a Nurse Practitioner. Control group (standard model): Patients remain in conventional physician-led care. Parameters assessed: Clinical outcomes: Blood pressure (systolic/diastolic), lipid levels (LDL-C), renal function (eGFR/creatinine), height, weight, BMI. Process indicators: Number of consultations (consultation frequency), frequency of referrals to cardiology, as well as number and duration of hospitalizations. Phase 2: Qualitative sub-study Subsequently, semi-structured interviews will be conducted with patients to further explore and contextualize the statistical findings. The focus will be on subjective satisfaction and the quality of the therapeutic relationship (Lincoln & Guba, 1985).
1. Age ≥ 18 years 2. Diagnosed or suspected cardiovascular disease 3. Confirmed cardiovascular diagnosis (ICD-10 I10–I15, I20–I25, I50, E78) and/or 3.1. Documented medical history and/or use of cardiovascular-related medication (e.g., antihypertensive agents, statins) and/or 3.2. Clinically justified suspicion of cardiovascular disease with an indication for cardiological evaluation, particularly in the presence of: Self-measured blood pressure values ≥ 135/85 mmHg Exertional dyspnea Stable chest tightness
1. Unstable acute conditions (e.g., cardiac decompensation, acute angina pectoris, or dyspnea) 2. Severe cognitive impairment 3. Inability to provide informed consent 4. Terminal illness 5. Current pregnancy 6. Concurrent participation in another clinical trial 7. Age under 18 years