Key result
NP-led virtual CAD care boosts BP target attainment by ~28 percentage points with rare escalation.
Why the study?
Virtual care offers a complementary pathway to in-person visits for managing stable coronary artery disease, but feasibility of a nurse practitioner-led virtual clinic for secondary prevention was not established.
Does an NP-led interdisciplinary virtual clinic maintain guideline-directed medical therapies, minimize in-person escalation, and achieve high patient satisfaction in adults with stable CAD?
Does an NP-led interdisciplinary virtual clinic maintain guideline-directed medical therapies, minimize in-person escalation, and achieve high patient satisfaction in adults with stable CAD?
A nurse practitioner-led interdisciplinary virtual clinic is a feasible, acceptable, and effective complementary model for delivering secondary prevention care to patients with stable CAD.
Supports virtual clinics for secondary prevention in stable CAD; extends feasibility data for remote models but requires larger trials.
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.
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Abdi et al. (2026) studied Stable coronary artery disease (CAD) (n=66). Nurse practitioner-led interdisciplinary virtual clinic vs. Baseline (pre-intervention) was evaluated on Maintenance of guideline-directed medical therapies (GDMT) and therapeutic targets, scheduled visits completed via video without in-person escalation, and patient satisfaction. An NP-led virtual clinic for stable CAD was feasible, with BP-target attainment improving from 48.8% to 76.7% and only 1.4% of visits requiring in-person escalation at 1 year.
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