Report: Nurse practitioners, docs have similar rates of inappropriate prescribing

Doctors and nurses are likely to inappropriately prescribe drugs to older adults at about the same rate regardless of their professional title, a new study finds.

Researchers looked at data from more than 73,000 primary care physicians (PCPs) and nurse practitioners (NPs). The authors say their research shows that nurse practitioners don’t perform worse than doctors when it comes to inappropriate prescriptions.

An inappropriate prescription is a drug that’s ordered for a person when the risk to using it is greater than the benefit. This is especially true if a safer or more effective alternative is available to the individual. 

Whether PCP or NP, the medical professionals averaged about 1.7 inappropriate prescriptions for every 100 prescriptions they wrote. The study was published Monday in Annals of Internal Medicine.

The research team from University of California, Los Angeles, Yale Law School and Stanford University measured inappropriate prescribing rates for 23,669 NPs and 50,060 PCPs who prescribed medications to older adults over the age of 65 in 29 states that allow NPs to prescribe medication.

The researchers gauged Inappropriate prescribing by using the American Geriatrics Society’s Beers Criteria.

The researchers are hoping policymakers, lawmakers and regulators use their data to lower the prevalence of inappropriate prescriptions. Clinician-level performance measures along with initiatives to improve prescribing at the organizational and individual levels could help to lower the rate among medical professionals who prescribe medication. Technology and prescription drug monitoring can play a role to make that happen, as can efforts to better adhere to the Beers criteria.

In an accompanying editorial, authors at University of California, Los Angeles, say the rates of inappropriate prescriptions are too high regardless of the type of clinician. According to the article, NPs provide a larger proportion of care to older adults compared to doctors, and need to be especially careful in their prescription choices.