Nurse practitioners, physicians have similar rates of inappropriate prescribing

Nurse practitioners are no more likely than physicians to prescribe inappropriately to older patients, a recent study found.

The study, published Oct. 24 in Annals of Internal Medicine, compared more than 23,000 nurse practitioners and 50,000 primary care physicians in 29 states where NPs had prescribing authority. They found between 2013 and 2019, the average rate of potentially inappropriate prescriptions was 1.7% for physicians and nurse practitioners.

Inappropriate prescribing was defined according to criteria from the American Geriatrics Society and essentially means prescriptions that may do more harm than good for older adults.

The study found that nurse practitioners had the widest variety of inappropriate prescriptions. Almost half of nurse practitioners were in the highest 10% and the lowest 10% for inappropriate prescribing.

"Broad efforts to improve the performance of all clinicians who prescribe may be more effective than limiting independent prescriptive authority to physicians," the authors wrote.

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