Chronic Disease Management in Resource-Constrained Rural Primary Care: The Expanding Role of the Rural Nurse Practitioner

Rural communities experience a disproportionate burden of chronic disease while facing shortages of clinicians, specialists, diagnostic services, pharmacies, and transportation. Nurse practitioners (NPs) often provide comprehensive management for diabetes, chronic kidney disease, and chronic obstructive pulmonary disease when specialty care is delayed or unavailable. This article examines the expanded role of rural NPs in delivering evidence-based, relationship-centered care within resource-constrained settings. It also addresses polypharmacy, social determinants of health, telehealth, community partnerships, and interprofessional collaboration. Strengthening rural chronic disease care requires supportive practice environments, workforce development, equitable reimbursement, broadband access, and policies enabling safe and sustainable NP practice.