Patient Safety | 11.02.23
NPs No More Likely Than Physicians to Prescribe Inappropriately to Older Adults
A recent analysis of Medicare Part D claims in found the mean rates of inappropriate prescribing by nurse practitioners (NPs) and primary care doctors were "virtually identical" at adjusted rates of 1.66 and 1.68 per 100 prescriptions, which the authors of an accompanying editorial found "to some extent reassuring." The researchers generally found that crude rates of inappropriate prescribing between NPs and primary care physicians stood at 1.63 versus 1.69 per 100 prescriptions. They commented that the adjusted averages "mask substantial underlying differences in inappropriate prescribing patterns," observing that NPs were overrepresented among clinicians with the highest and lowest rates of inappropriate prescribing. Cross-state variations in inappropriate prescribing were larger than disparities between clinicians within states, with Utah and Virginia having the highest rates of inappropriate prescribing for both NPs and physicians -- nearly twice that of the corresponding rates in low-rated Hawaii and the District of Columbia. The authors concluded that there remains “substantial variation in potentially inappropriate prescribing among clinicians of all stripes."