Nurse Practitioner Practice and Controlled Substances in Ontario: Current Practice and Future Intent.

Area of Science:

• Nursing Practice
• Pharmacology
• Health Policy

Background:

• Canadian regulations permit nurse practitioners (NPs) to prescribe controlled substances since 2012.
• Ontario provincial law currently prohibits NPs from prescribing controlled substances.
• The College of Nurses of Ontario (CNO) surveyed NPs to guide future regulations.

Purpose of the Study:

• Assess current NP practices with patients needing controlled substances.
• Identify NP learning needs for prescribing controlled substances.
• Determine NPs' intent to prescribe controlled substances if authorized.

Main Methods:

• An online survey was distributed to 1,447 Ontario NPs in 2013.
• The sample included NPs with Adult, Pediatrics, and Primary Healthcare Specialty Certificates.
• A total of 529 NPs (37% response rate) completed the survey.

Main Results:

• 71% of surveyed NPs would prescribe controlled substances if legally permitted.
• NPs in specialized practice (79%) were more likely to prescribe than generalist NPs (66%).
• 64% of NPs identified a need for additional education, particularly in pharmacotherapy, jurisprudence, and risk management (addiction, diversion, misuse).

Conclusions:

• A majority of Ontario NPs are prepared to prescribe controlled substances, indicating a need for regulatory changes.
• Significant educational needs exist for NPs to safely and effectively prescribe controlled substances.
• Survey findings can inform policy development for NP prescribing of controlled substances across Canada.