Primary care Advanced Practice Nurses experiences in management of patients with complex chronic conditions
Applied/Translational Research
Care Continuum
Singapore Health Biomedical Congress
National Healthcare Group
11 February 2026
The study aimed to explore primary care Advanced Practice Nurses (APNs) definitions of complexity, perceived positive. Primary care CDM APNs' understanding of complexity align with primary care physicians, encompassing medical, psychosocial, and.
Year Submitted: 2025
Published Date: 11 February 2026
Tags: Technology, Care Process ＆ Redesign, Video/Video Conferencing
About this Content
Aims
The study aimed to explore primary care Advanced Practice Nurses (APNs) definitions of complexity, perceived positive aspects and challenges of managing complex chronic patients.
Methods
This descriptive study was conducted among chronic disease management (CDM) APNs in all three polyclinic clusters. Online anonymous survey with open-ended questions was used to collect data. Thematic analysis was done for APNs definitions, perceived positive aspects and challenges of managing complexity.
Results
Eighteen primary care CDM APNs completed the survey; 50% had 10 years of APN experience. APNs defined complexity across medical, psychosocial and behavioral domains. Medical complexity included poorly controlled or treatment-resistant chronic conditions, multi-morbidity, polypharmacy, recent or multiple hospitalizations, and acute presentations during chronic consults. Psychosocial complexity manifested in mental health conditions and inadequate social support, while behavioural complexity was primarily reflected in suboptimal treatment adherence. APNs identified professional satisfaction from witnessing improvements in patients' conditions and opportunities for enhanced clinical knowledge and critical thinking as key positive aspects. Time constraints emerged as the main challenge in managing complexity. APNs also highlighted the importance of training specific to complexity in primary care and physician support.
Lessons Learnt
Primary care CDM APNs' understanding of complexity align with primary care physicians, encompassing medical, psychosocial, and behavioural domains. The study provided insights into positive aspects of managing complexity while highlighting challenges. Positive aspects should be emphasized and challenges addressed to support APNs in managing complexity.
Keywords
Chronic disease magaement, complexity, Advanced Practice Nurses
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | National Healthcare Group Polyclinics, National University Polyclinics, SingHealth Polyclinics |
Platform(s) | Singapore Health Biomedical Congress |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Nursing, Nursing Education, Nursing Research |
Project Lead(s) | Jacqueline De Roza |
Project Member(s) | Angelica Wu |
Connect with this contributor!
Jacqueline De Roza - jacqueline.g.de.roza@nhghealth.com.sg