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Annals of Internal MedicineInappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians

Inappropriate Prescribing: A Shared Challenge for Nurse Practitioners and Physicians

A recent study published in the Annals of Internal Medicine has revealed that nurse practitioners (NPs) and primary care physicians (PCPs) show similar rates of inappropriate prescriptions for older patients. This study provides valuable insights into the prescribing habits of NPs and PCPs, contributing to the ongoing discussion about the role of NPs in addressing the shortage of PCPs in the United States as well as the broader implications for healthcare policy, particularly in states considering expanding prescriptive authority to nurse practitioners.

Study Design

  • The study involved more than 73,000 primary care physicians (PCPs) and nurse practitioners (NPs).
  • The researchers calculated inappropriate prescribing rates for 23,669 NPs and 50,060 PCPs prescribing medications to patients aged 65 years and older across 29 states that have granted NPs prescriptive authority.
  • Inappropriate prescribing was defined using the American Geriatrics Society’s Beers Criteria.

Key Findings

  • Both PCPs and NPs averaged approximately 1.7 inappropriate prescriptions for every 100 prescriptions written.
  • However, NPs were overrepresented among clinicians with the highest and the lowest rates of inappropriate prescribing.
  • The authors suggest that use of clinician-level performance measures, coupled with efforts to improve prescribing at the organizational and individual levels, could help to address deficient performance among all clinicians who prescribe.

According to a report by the National Center for Biotechnology Information, nearly half of older adults take one or more medications that are not medically necessary.

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