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Physician assistant and nurse practitioner prescribing: 1997-2002
Roderick S Hooker1, Daisha J Cipher
1Department of Veterans Affairs, Medical Service (111), 4500 S. Lancaster Road, Dallas, TX 75216-7191, USA. roderick.hooker@med.va.gov
Summary
Physician assistants (PAs) and nurse practitioners (NPs) prescribe similarly to physicians overall. However, prescribing patterns differ in rural areas, warranting further investigation into these provider differences.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Pharmacology
Background:
- Physician assistants (PAs) and nurse practitioners (NPs) possess broad practice authority, including prescriptive authority in most states.
- Limited national data exists comparing PA and NP practice patterns in urban versus rural settings.
Purpose of the Study:
- To characterize and compare prescribing practices of PAs, NPs, and physicians.
- To analyze provider, patient, and prescription data across metropolitan and nonmetropolitan areas.
Main Methods:
- Utilized the National Ambulatory Medical Care Survey (NAMCS) data.
- Analyzed 149,202 primary care visits with prescriptions from 1997-2002.
- Compared prescribing activities of PAs, NPs, and physicians.
Main Results:
- PAs and NPs accounted for 3% of primary care visits and prescribed in 60-70% of these visits.
- PAs were more likely to prescribe controlled substances compared to physicians and NPs.
- Significant prescribing differences emerged in rural areas, with NPs prescribing more and PAs prescribing less than physicians.
Conclusions:
- PAs and NPs generally mirror physician prescribing habits in medication management.
- Prescribing variations among PAs, NPs, and physicians in nonmetropolitan areas require additional study.
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