Collaborative Primary-Care Workforce Models: An Integrative Review of Evidence Informing RN Prescriber Integration...

Background/Objectives: Registered nurse (RN) prescribing is increasingly discussed as a strategy to improve primary-care access, medication follow-up, chronic disease management, and service responsiveness. The available evidence, however, does not directly test a single coordinated RN prescriber-family physician/nurse practitioner (FP/NP) model. This integrative review synthesized heterogeneous evidence relevant to how RN prescribing may be organized within team-based primary care. Methods: A structured integrative review approach was used to map evidence from nurse and non-medical prescribing, RN-led primary care, nurse-physician substitution, interprofessional collaboration, chronic disease medication titration, patient-experience, and implementation research. Searches completed on 30 March 2026 included PubMed/MEDLINE, PubMed Central, the Cochrane Library search interface, publisher full-text platforms, targeted scholarly searches, citation chasing, and Canadian regulatory/professional sources. Methodological quality was appraised using AMSTAR 2- and CASP-informed criteria, and the strength of interpretation was assessed narratively. No meta-analysis was performed because of substantial heterogeneity and the risk of double-counting primary studies included in prior evidence syntheses. Results: A total of 286 records were identified. After de-duplication, screening, and eligibility assessment, 37 peer-reviewed records were included: 30 review-level or evidence-synthesis records and 7 primary, mixed-methods, or patient-experience studies. Four official regulatory/professional sources were retained separately for context. Nurse and non-medical prescribing were generally associated with comparable or favourable outcomes for blood pressure, glycated hemoglobin, low-density lipoprotein cholesterol, medication adherence, patient satisfaction, and selected access outcomes in defined contexts. Direct evidence for the exact RN prescriber-FP/NP configuration remains limited. Conclusions: Current evidence is consistent with a coordinated RN prescribing model embedded within primary-care teams, but does not establish causal superiority of this configuration over other models. Coordinated RN prescribing should therefore be understood as an evidence-informed and testable implementation model requiring prospective evaluation, particularly for diagnostic safety, adverse events, continuity, workload, cost, and patient-level outcomes.