Prescriptive practice differences between nurse practitioners and physicians in the treatment of uncomplicated...

Nurse practitioners (NPs) have increasingly broad prescribing authority, yet there is insufficient information available on the prescribing practices of NPs working in the emergency department setting.

The purpose of this study was to describe prescriptive practices between two provider groups, NPs and physicians, in an emergency department setting in the United Arab Emirates. This comparison focused on treatment of a common emergency department diagnosis of uncomplicated urinary tract infection (UTI).

The investigators reviewed a sample of 690 UTI patients during the period of August 30, 2016 to June 30, 2018. Physician and NP provider groups were then assessed for treatment selection and associated patient outcomes. A Chi-square test was used to compare empiric antibiotic selection using variables of population type, gender, age, and provider type.

There were similar prescriptive practices for beta-lactam, nitrofurantoin, and trimethoprim prescriptions. The investigators noted a statistical difference for fluoroquinolone use, with the physician group selecting fluoroquinolones more often than the NP group. Also, fluoroquinolone use within the physician group varied significantly; however, the investigators did not see this within the NP group.

The findings support that there is comparable care quality in the treatment of uncomplicated UTIs between physician providers and NPs in this setting. Comparing outcome similarities and differences on a commonly occurring medical problem in the emergency department provides an early look at the value-added services that NPs provide.