Nurse Practitioner–Directed Cardio-Diabetes Pilot Program

• Published in: Journal for nurse practitioners 2020-09, Vol.16 (8), p.e123-e128
• Main Authors: Bryant, Eryn, Janaszek, Katherine, Nejedly, Mary, Li, Erin, Bouvier, Monique, Schroeder, Karia, Khandelwal, Abha, Lough, Mary E., Lamendola, Cindy, Reisenberg, Amy, Purewal, Saira, Maron, David J.
• Format: Article
• Language: English
• Subjects: Algorithms; Atherosclerosis; atherosclerotic cardiovascular disease (ASCVD); Cardiology; Clinical decision making; Clinical medicine; Diabetes; Dietitians; Drug therapy; Endocrinology; Feasibility; GLP-1 receptor agonists; Glucagon; glucagon-like peptide 1 receptor agonist (GLP1-RA); Glucose; Group decision making; Insulin; Medical referrals; Nurse practitioners; Patient compliance; Patient-centered care; shared decision making (SDM); Sodium; sodium-glucose cotransporter-2 inhibitor (SGLT2-I); Stroke; Type 2 diabetes mellitus; type 2 Diabetes Mellitus (T2DM)
• ISSN: 1555-4155; 1878-058X
• DOI: 10.1016/j.nurpra.2020.05.009

Historically, antihyperglycemics for patients with Type 2 diabetes have not been managed by cardiology clinicians. This paradigm has shifted after the release of cardiovascular (CV) outcome trials using 2 new classes of antihyperglycemics agents, sodium-glucose cotransporter-2 inhibitors or glucagon-like peptide 1 receptor agonists, which demonstrated a decrease in all-cause mortality, CV death, and stroke. The purpose of this pilot program was to translate this trial data into practice by developing a protocol for cardiology-based nurse practitioners (NPs) to initiate these agents. Cardiology NPs demonstrated the feasibility of initiating these agents within a cardiology practice using a shared decision-making, patient-centric framework. •Newer antiglycemic medications have proven cardiovascular benefit.•Translation of evidence into patient-centered clinical practice was studied.•The process of developing a protocol to implement evidence-based care is described.