By Joe Gorelick, MSN, FNP-C
Are nurse practitioners any more likely than primary care physicians to inappropriately prescribe drugs to older patients? Findings from a comprehensive analysis of prescribing patterns in 29 states over six years indicate they are not. In fact, NPs were overrepresented among prescribers with the lowest rates of inappropriate prescribing.
Overall, both physicians and NPs averaged approximately 1.7 inappropriate prescriptions for every 100 prescriptions written. Unfortunately, NPs were also over-represented among inappropriate prescribers.
The study in the Annals of Internal Medicine analyzed data from more than 73,000 primary care physicians and nurse practitioners and is the largest of its kind. Using comprehensive data on medications prescribed to Medicare beneficiaries, researchers calculated and compared rates of inappropriate prescribing to older patients. They defined inappropriateness according to the Beers Criteria developed by the American Geriatrics Society.
Researchers identified substantial variation in prescribing quality in the 29 states. Variation in prescribing quality from state-to-state was much greater than differences in quality between nurse practitioners and primary care physicians in any given state.