Document Type
Article
Publication Title
BMJ open quality
Abstract
Background Virtual care offers a complementary pathway to in-person visits for managing coronary artery disease (CAD). This study evaluated the feasibility of a nurse practitioner (NP)-led interdisciplinary virtual clinic dedicated to secondary prevention for individuals with stable CAD.
Methods A feasibility study was conducted in an academic cardiology practice in Canada from July 2021 to July 2024. A convenience sample of adults ≥18 years of age with stable CAD was included; each participant received at least one annual NP-led video visit reviewed with a cardiologist asynchronously. Primary outcomes: 1) percentage of self-reported maintenance of guideline-directed medical therapies (GDMT) and achieving therapeutic targets pre and post-intervention, 2) percentage of scheduled visits completed via video without need to escalate to in-person care and 3) patient satisfaction.
Results A total of 66 participants (median age 67, 73% male) were enrolled; 43 completed a 1 year follow-up at the time of data collection (median age 67, 77% male). Self-reported GDMT use remained high and the proportion meeting lipid targets was similar at baseline and follow-up. BP-target attainment was 48.8% at baseline and 76.7% at follow-up among those with available data. At 1 year, only 2 out of 145 (1.4%) completed visits required an in-person escalation. Of 58 completed patient satisfaction surveys, 91% of respondents reported being satisfied or very satisfied with their care and 77.6% rated their virtual visit as equal to or better than an in-person visit.
Conclusions An NP-led interdisciplinary virtual clinic appears feasible and safe for delivering secondary prevention to individuals with stable CAD, with few in-person escalations and high patient satisfaction. Further studies are required to determine the long-term impact and effectiveness of this approach on GDMT optimisation and achievement of therapeutic targets.
First Page
1
Last Page
7
DOI
10.1136/bmjoq-2026-004408
Publication Date
10-15-2026
Recommended Citation
Abdi A, Rector H, Hung V, Akhtari S. Evaluating the quality and safety of a nurse practitioner-led virtual clinic for secondary prevention in stable coronary artery disease: a pilot feasibility study. BMJ Open Qual. 2026 Oct 15;15(4):e004408. doi: 10.1136/bmjoq-2026-004408. PMID: 42880904.