Advanced practice nursing in vascular medicine in France: Implementation, roles, and patient outcomes

Advanced Practice Nurses (APNs) were introduced in France in 2019 to address chronic disease burden, healthcare access inequalities, and medical workforce shortages. By the end of 2024, 751 APNs had graduated in France, with Stabilized Chronic Diseases (PCS) representing the predominant specialty (54-57%). APNs specialized in Stabilized Chronic Diseases are expected to collaborate with vascular physicians, although their role continues to evolve following recent authorization of direct patient access and independent prescribing rights. This study aimed to assess the implementation of APNs in vascular medicine in France.

An online survey was conducted between December 2025 and February 2026 among French vascular physicians through the mailing list of the Collège des enseignants en médecine vasculaire. Separate questionnaires were distributed to APNs and vascular physicians to evaluate referral pathways, clinical activities, delegated tasks, and prescribing practices.

Four hospital-based APNs and 40 vascular physicians participated in the survey. APN activities mainly included therapeutic education, chronic wound management, thromboembolic disease follow-up, and technical vascular assessments such as ankle-brachial index measurements and walking tests. Thirty-three physicians reported active collaboration with APNs, mainly for follow-up consultations and to reduce delays in specialist care. However, cardiovascular risk factor management remained limited, and only 61.8% of physicians supported independent prescribing authority for APNs.

APNs are progressively being integrated into vascular medicine teams in France, particularly in hospital settings. Although international evidence supports the safety and effectiveness of APN-led care, clearer role definition and broader integration into chronic vascular disease management remain necessary within the French healthcare system.