Perceptions, perspectives and experiences of adult patients attending nurse-led clinics: a mixed-method systematic review

BACKGROUND: Nurse-led clinics (NLCs) are structured models of care in which nurses assume primary responsibility for patient care, often practising autonomously within multidisciplinary teams across all healthcare settings. Developed to address rising clinical demands, workforce shortages, and the growing chronic disease burden, NLCs play a key role in delivering accessible, holistic, patient-centred care led by advanced practice nurses. Although a qualitative systematic review of patient experiences with NLCs was conducted in 2012, evolving models of care and research designs highlight the need for updated evidence. Accordingly, this mixed-methods systematic review employs a narrative synthesis approach to examine and synthesise the perceptions, perspectives, and experiences of adult patients attending NLCs, including factors that influence these perceptions. METHODS: Published research from 2012 to April 2025 was retrieved using the electronic databases MEDLINE, CINAHL, Embase, Scopus, and PsycINFO using a comprehensive search strategy. All articles were collated in EndNote and screened via COVIDENCE by two independent reviewers. Data were extracted from the articles that met the inclusion criteria using a standardised form. Quality appraisal was undertaken using JBI critical appraisal tools. RESULTS: A total of 3185 articles were identified of which 23 studies met the inclusion criteria were included in the final synthesis. A mix of quantitative and qualitative methodologies were applied in these articles, with 12 using a cross-sectional design with a structured patient satisfaction survey, seven of these studies employed a qualitative approach while four studies used a mixed method approach. Key findings identified include patient satisfaction with the length of consultation time, the confidence in the care provided by the APN, decreased waiting times, improved confidence in managing disease, continuity of care, person centred approach and the feeling of being involved in the decision making. NLCs generally met patient expectations, with patients reporting satisfaction, accessibility, increased knowledge, timely access, service acceptability, and holistic care. CONCLUSION: This review demonstrated that patients highly value nurse-led clinics across diverse healthcare settings for their accessibility, continuity, timeliness, and the holistic care provided by APNs. These insights can guide future service improvements and enhance patient experiences. CLINICAL TRIAL NUMBER: Not applicable.