Resident Registered Nurse Anesthetists' Use of Cognitive Enhancers in the U.S

Graduate students, including medical students, use cognitive enhancer (CE) medications with or without legal prescription to aid academic performance despite little evidence that they improve performance in individuals without a medical diagnosis and subsequent prescription. However, there is limited information on CE medication use, with or without legal prescription, by resident registered nurse anesthetists (RRNAs). This cross-sectional survey assessed prevalence of CE medication use with or without legal prescription and its potential predictors (depression, anxiety, Attention Deficit Hyperactivity Disorder [ADHD] symptoms, and demographic variables) in 421 RRNAs. Descriptive and binary logistic regression analyses were conducted. The prevalence of CE use with or without prescription was 27.3%, with 93% obtained by prescription. The prevalence of clinically significant symptoms of ADHD (25.7%), depression (26.9%), and anxiety (23.1%) were assessed among RRNAs. No significant differences in age, gender, or program years were observed between CE medication users with or without legal prescription and CE non-users. However, white respondents were more likely to be CE medication users with or without legal prescription compared with respondents of other racial groups (P = .020). In the full logistic regression model, ADHD (aOR, 1.17; 95% CI, 1.10-1.24) was associated with increased odds of CE use. The Backward stepwise selection model retained ADHD and anxiety as significant predictors.