Global Economic Evaluation of the Nurse Prescribing of Medication Role: A Scoping Review

There is a paucity of evidence and reports addressing the Economic Evaluation in Health (EEH) of the implementation of the Nurse Prescribing of Medication (NPM) role. Consequently, there is limited knowledge about the economic costs and the overall impact of NPM on healthcare systems worldwide where it has been implemented. This gap of knowledge limits the ability of other nations to determine whether adopting this initiative would be beneficial. A few countries have published their NPM economic benefits, though available scientific publications have focused on NPM clinical effectiveness, particularly regarding quality and safety in patient care.

This review aimed at mapping the current knowledge about the role played by the NPM internationally in terms of EEH in terms of direct and indirect economic benefits for cost minimization, cost-effectiveness, cost-utility, cost-benefit, return on investment and healthcare cost savings.

A scoping review of international literature was conducted based on the PRISMA-ScR checklist and the Johanna Briggs Institute Guide to identify scientific evidence and relevant grey literature on the review topic.

The search strategy was conducted in four bibliographic databases of Scopus, Web of Science, PubMed (covering Medline) and Google Scholar, with no time restrictions, covering publications up to 30 September 2024. The search was performed in both English and Spanish, selecting relevant publications based on inclusion and exclusion criteria. For research synthesis and data analysis, two summaries were developed: one summarizing the findings from the scientific literature search and the other summarizing the results from the grey literature search.

The 26 included studies in this scoping review suggest a positive EEH across various countries where its implementation has led to enhanced efficiency, reduced healthcare costs and improved economic profitability. The actions carried out for decades in those countries represent a significant reduction in direct and indirect costs, also in medical supplies and waiting lists, as well as an increase in the quality of patient care leading to a positive contribution to healthcare systems' sustainability.

Improving the conditions and utilization of NPM is essential to maximize nurses' contribution to patient care within healthcare systems. More high-quality research is required to identify and examine economic effectiveness and healthcare cost savings by governments and other healthcare organizations, given that evidence regarding the benefits of the NPM role globally is insufficient.