LOS ANGELES—Results of a descriptive survey regarding the role of nurse practitioners/physician assistants (NPs/PAs) in headache care reveal role overlap between physicians, NPs, and PAs when caring for patients with headache. Survey results were presented at the 56th Annual Scientific Meeting of the American Headache Society. Findings from the study “highlight interprofessional educational opportunities and establish a guide for collaborative work,” said study authors Maureen Moriarty, DNP, ANP-BC, and J. Michael Jones, PA-C, who are both members of the NP/PA Special Interest Section of the American Headache Society.
During an NP/PA Special Interest Group meeting at the 2012 Annual Meeting of the American Headache Society, discussion revealed disparities in the following areas: clinical, educational, and research responsibilities; practice settings; reimbursement strategies; and compensation. The range of opinions, combined with scant published information regarding these roles in headache practices identified a knowledge gap.
Maureen Moriarty, DNP, ANP-BC
After the meeting, a 33-item questionnaire was distributed to all NP and PA members of the American Headache Society and to physician members who work with NPs or PAs. Questionnaire domains included credentialing; practice setting; clinical, educational, and research roles; reimbursement strategies; compensation; and views on interprofessional practice.
Of 42 total respondents, 29 (69%) were NPs and 13 (31%) were PAs. The vast majority (97%) of respondents worked in an ambulatory practice setting. Nearly 25% had been in practice for less than one year. Roughly the same number had been in practice from two to five years. Nearly 20% had been practicing for six to 10 years. About 30% had been practicing for more than 11 years.
Regarding roles and duties, 91% reported that they evaluated new patients, either alone or collaboratively. Nearly all (97%) said that they evaluated returning patients. Almost all (95%) prescribed medications.
Nearly 90% reported that they performed procedures such as nerve blocks and onabotulinumtoxinA injections. Additional duties reported included patient education and research.
“Disseminating this information raises awareness of previously hidden though effective roles,” said lead study author Ms. Moriarty, who is the Director of the Post-Masters Doctor of Nursing Practice Program in the School of Nursing and Health Studies at Georgetown University. The majority of respondents are practicing collaboratively with physicians. Evidence of NP/PA reimbursement for services, NP/PA effectiveness as patient educators, and their role in evaluation and management of benign headache conditions were cited as some of the economic benefits (both financial and timesaving) of interprofessional practice.
The investigators hope to expand their research and capture data from non-American Headache Society member NPs and PAs in neurology practices. They also hope to gather demographic information regarding practice location because the scope of practice varies from state to state.
—Glenn S. Williams