期刊
MEDICAL CARE RESEARCH AND REVIEW
卷 79, 期 2, 页码 290-298出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/10775587211004311
关键词
buprenorphine prescribing; nurse practitioners; scope-of-practice regulations; Comprehensive Addiction and Recovery Act
资金
- National Institute on Drug Abuse [R01 DA039928, R01 DA047379-01A1]
- Indiana University Addictions Grand Challenge initiatives
- Alkermes, Inc.
- Health Foundation of South Florida
- Centers for Disease Control and Prevention
- Robert Wood Johnson Foundation
- Florida Office of the State Courts Administrator
- National Institutes of Health
- National Council of State Boards of Nursing
- Indiana University's Grand Challenge Initiatives
- SPEA Postdoctoral Fellows on Regulatory Reform program
This study found that less restrictive state scope-of-practice regulations for nurse practitioners are associated with more prescriptions written by NPs. Even in rural areas, the percentage of buprenorphine prescriptions written by NPs remains relatively low.
This article examines the relationship between federal regulations, state scope-of-practice regulations on nurse practitioners (NPs), and buprenorphine prescribing patterns using pharmacy claims data from Optum's deidentified Clinformatics Data Mart between January 2015 and September 2018. The county-level proportion of patients filling prescriptions written by NPs was low even after the 2016 Comprehensive Addiction and Recovery Act (CARA), 2.7% in states that did not require physician oversight of NPs, and 1.1% in states that did. While analyses in rural counties showed higher rates of buprenorphine prescriptions written by NPs, rates were still considerably low: 3.7% in states with less restrictive regulations and 1.1% in other states. These results indicate that less restrictive scope-of-practice regulations are associated with greater NP prescribing following CARA. The small magnitude of the changes indicates that federal attempts to expand treatment access through CARA have been limited.
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