Administrative claims data analysis of nurse practitioner prescribing for older adults

Murphy, Andrea; Martin-Misener, Ruth; Cooke, Charmaine; Sketris, Ingrid

doi:10.1111/j.1365-2648.2009.05069.x

Cited by 8 publications

(18 citation statements)

References 35 publications

(73 reference statements)

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“…Four studies from UK, Canada, Botswana and Zimbabwe, which analysed patient clinical accounts, reported substantial increases in the prescription by NMP of non-steroidal anti-inflammatory [49], cardiovascular [50] and antibiotic medicines [54-56]. They give an indication of both the conditions that non-medical prescribers were encountering and also of the numbers or confidence of non-medical prescribers to prescribe these medicines.…”

Section: Resultsmentioning

confidence: 99%

“…An analysis of patient records found that patients experienced short waiting times (63% waited 15 minutes or less) [53]. A Canadian study which analysed two years of prescription claims by older adults reported that the number of prescriptions per nurse prescriber doubled and cost per prescription increased approximately 20% over the time period [49]. The authors noted the increase in cost per prescription; however, they did not interpret this in terms of efficiency.…”

Section: Resultsmentioning

confidence: 99%

“…The authors noted the increase in cost per prescription; however, they did not interpret this in terms of efficiency. While three studies describing the professional views [[44,49] and [55]] reported that NMP was time saving for patient and nurses only one study, which was conducted in the UK, reported NMP as a cost-effective intervention [47]. …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Bhanbhro

Drennan

Grant

et al. 2011

BMC Health Serv Res

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BackgroundSafe and timely access to effective and appropriate medication through primary care settings is a major concern for all countries addressing both acute and chronic disease burdens. Legislation for nurses and other professionals allied to medicine to prescribe exists in a minority of countries, with more considering introducing legislation. Although there is variation in the range of medicines permitted to be prescribed, questions remain as to the contribution prescribing by nurses and professionals allied to medicine makes to the care of patients in primary care and what is the evidence on which clinicians, commissioners of services and policy makers can consider this innovation.MethodsA integrative review of literature on non-medical prescribing in primary care was undertaken guided by dimensions of health care quality: effectiveness, acceptability, efficiency and access.Results19 papers of 17 empirical studies were identified which provided evidence of patient outcome of non medical prescribing in primary care settings. The majority were undertaken in the UK with only one each from the USA, Canada, Botswana and Zimbabwe. Only two studies investigated clinical outcomes of non-medical prescribing. Seven papers reported on qualitative designs and four of these had fewer than ten participants. Most studies reported that non medical prescribing was widely accepted and viewed positively by patients and professionals.ConclusionsPrimary health care is the setting where timely access to safe and appropriate medicines is most critical for the well-being of any population. The gradual growth over time of legislative authority and in the numbers of non-medical prescribers, particularly nurses, in some countries suggests that the acceptability of non-medical prescribing is based on the perceived value to the health care system as a whole. Our review suggests that there are substantial gaps in the knowledge base to help evidence based policy making in this arena. We suggest that future studies of non-medical prescribing in primary care focus on the broad range of patient and health service outcomes and include economic dimensions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Bhanbhro

Drennan

Grant

et al. 2011

BMC Health Serv Res

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“…, Murphy et al . ). Oral antimicrobials were the most prescribed groups in terms of volume and cost over the three years in an analysis of administrative claims by Canadian NPs prescribing for older adults (Murphy et al .…”

Section: Discussionmentioning

confidence: 97%

Nurse practitioner prescribing practices: the most frequently prescribed medications

Buckley

Cashin

Stuart

et al. 2013

Journal of Clinical Nursing

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Findings highlight the importance of Nurse Practitioner's a capacity to prescribe wide variety of medications, especially in practice areas such acute, primary and emergency care. The unique role nurse practitioners in relation to management of patients with infective processes and patients requiring pain relief is highlighted. Insight into current Nurse Practitioner prescribing trends informs future Nurse Practitioner curricular and future continuing education programmes. Findings give unique insight for future service planning, especially service providers considering introducing nurse practitioners to their service. The finding that nurse practitioners prescribing patterns are similar to other non-nurse practitioner prescribers in Australia highlights the potential for service providers to introduce new models of care that are Nurse Practitioner lead.

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“…The adoption of health care innovation also changes over time. Studies of nurse prescribing to date have drawn prescribing evidence at single points in time or from aggregated data [12,13,35,36], often in relation to programmes targeted at specific patient populations [5,37] or particular types of medicines such as analgesics or antidepressants [38,39]. …”

Section: Introductionmentioning

confidence: 99%

Trends over time in prescribing by English primary care nurses: a secondary analysis of a national prescription database

Drennan

Grant

Harris

2014

BMC Health Serv Res

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BackgroundA growing number of countries legislate for nurses to have medication prescribing authority although it is a contested issue. The UK is one of these countries, giving authority to nurses with additional qualifications since 1992 and incrementally widened the scope of nurse prescribing, most recently in 2006. The policy intention for primary care was to improve efficiency in service delivery through flexibility between medical and nursing roles. The extent to which this has occurred is uncertain. This study investigated nurses prescribing activities, over time, in English primary care settings.MethodsA secondary data analysis of a national primary care prescription database 2006-2010 and National Health Service workforce database 2010 was undertaken.ResultsThe numbers of nurses issuing more than one prescription annually in primary care rose from 13,391 in 2006 to 15,841 in 2010. This represented forty three percent of those with prescribing qualifications and authorisation from their employers. The number of items prescribed by nurses rose from 1.1% to 1.5% of total items prescribed in primary care. The greatest volume of items prescribed by independent nurse prescribers was in the category of penicillins, followed by dressings. However, the category where independent nurse prescribers contributed the largest proportion of all primary care prescriptions was emergency contraception (9.1%). In contrast, community practitioner nurse prescribers’ greatest volume and contribution was in the category of gel and colloid dressings (27%), medicated stockings (14.5%) and incontinence appliances (4.2%). There were slightly higher rates of nurse prescribing in areas with higher levels of socio-economic deprivation and fewer physicians per capita, but the correlations were weak and warrant further investigation.ConclusionsThe percentage of prescriptions written by nurses in primary care in England is very small in comparison to physicians. Our findings suggest that nurse prescribing is used where it is seen to have relative advantage by all stakeholders, in particular when it supports efficiency in nursing practice and also health promotion activities by nurses in general practice. It is in these areas that there appears to be flexibility in the prescribing role between nurses and general practitioners.

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Administrative claims data analysis of nurse practitioner prescribing for older adults

Cited by 8 publications

References 35 publications

Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Nurse practitioner prescribing practices: the most frequently prescribed medications

Trends over time in prescribing by English primary care nurses: a secondary analysis of a national prescription database

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