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Advanced practice psychiatric nurses as a treatment resource: survey and analysis
Saul Feldman1, John Bachman, Brian Cuffel
1United Behavioral Health, San Francisco, CA 94105, USA.
Administration and Policy in Mental Health
|September 19, 2003
Summary
Advanced practice psychiatric nurses (APPNs) with prescribing authority are as competent as psychiatrists in pharmacotherapy. Increasing APPNs could improve access to behavioral health services for public sector beneficiaries.
Area of Science:
- Psychiatry
- Nursing
- Health Services Research
Background:
- Access to behavioral health services, especially pharmacotherapy, is a significant challenge for public sector beneficiaries and managed care members.
- Advanced practice psychiatric nurses (APPNs) with prescribing privileges offer a potential solution to improve service availability.
Purpose of the Study:
- To assess the availability and prescribing competence of APPNs.
- To compare the prescribing practices and clinical outcomes of APPNs with those of psychiatrists.
Main Methods:
- A national survey of APPNs regarding their availability and prescribing practices.
- Comparative analysis of pharmacy claims data from APPNs and psychiatrists.
- Retrospective clinical record review comparing APPNs and psychiatrists.
Main Results:
- Approximately 25% of surveyed APPNs reported having prescription authority and private practices.
- Analysis of prescribing practices revealed no significant differences between APPNs and psychiatrists, with minor exceptions.
- Clinical record reviews also showed comparable performance between APPNs and psychiatrists.
Conclusions:
- APPNs demonstrate comparable competence to psychiatrists in pharmacotherapy.
- Recommendations include increasing the supply of APPNs to enhance behavioral health service accessibility.