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Tytuł pozycji:

Potentially inappropriate medication prescribing by nurse practitioners and physicians.

Tytuł:
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
Autorzy:
Chou LN; Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas, USA.; Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA.
Kuo YF; Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas, USA.; Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA.; Department in Internal Medicine, Division of Geriatrics and Palliative Care, University of Texas Medical Branch, Galveston, Texas, USA.; Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA.
Raji MA; Department in Internal Medicine, Division of Geriatrics and Palliative Care, University of Texas Medical Branch, Galveston, Texas, USA.; Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA.
Goodwin JS; Department in Internal Medicine, Division of Geriatrics and Palliative Care, University of Texas Medical Branch, Galveston, Texas, USA.; Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA.
Źródło:
Journal of the American Geriatrics Society [J Am Geriatr Soc] 2021 Jul; Vol. 69 (7), pp. 1916-1924. Date of Electronic Publication: 2021 Mar 22.
Typ publikacji:
Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
Język:
English
Imprint Name(s):
Publication: Malden, MA : Blackwell Science
Original Publication: New York [etc.]
MeSH Terms:
Ambulatory Care/*statistics & numerical data
Hospitalization/*statistics & numerical data
Inappropriate Prescribing/*statistics & numerical data
Nurse Practitioners/*statistics & numerical data
Physicians/*statistics & numerical data
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Medicare ; Odds Ratio ; Risk Factors ; Texas ; United States
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Grant Information:
P30 AG024832 United States AG NIA NIH HHS; R01 HS020642 United States HS AHRQ HHS; P30-AG024832 United States AG NIA NIH HHS; R01HS020642 United States HS AHRQ HHS
Contributed Indexing:
Keywords: nurse practitioners; potentially inappropriate medication; quality of prescribing
Entry Date(s):
Date Created: 20210322 Date Completed: 20211011 Latest Revision: 20220716
Update Code:
20240105
PubMed Central ID:
PMC8273104
DOI:
10.1111/jgs.17120
PMID:
33749843
Czasopismo naukowe
Background: Potentially inappropriate medication (PIM) use is a risk factor for hospitalization and mortality. However, there were few studies focusing on the impact of provider type on PIM use.
Objective: We aimed to estimate the initial and refill PIM prescribing rate for physician visits and nurse practitioner (NP) visits and the impact of provider type on PIM prescribing.
Research Design: We used 100% Texas Medicare data to define physician visits and NP visits in 2016. The rate of visits with a PIM prescription from the same provider was measured, distinguishing between initial and refill prescription to estimate the PIM rate and adjusted odds ratio (OR) by provider type.
Results: There were 24.1 per 1000 visits with a prescription for a PIM: 9.0 per 1000 visits for an initial PIM and 15.1 per 1000 visits for a refill PIM. A visit to an NP was less likely to result in an initial (OR = 0.74, 95% confidence interval [CI] = 0.70-0.79) or refill (OR = 0.54, 95% CI = 0.51-0.57) PIM. The association of lower odds of receiving a prescription for an initial PIM from an NP was substantially stronger among black enrollees than white enrollees (OR = 0.44, 95%CI = 0.30-0.65 for blacks and OR = 0.73, 95%CI = 0.68-0.78 for white enrollees). The association of an NP provider with lower odds of receiving a PIM refill was more pronounced in older patients and in those with more comorbidities.
Conclusions: NPs prescribed fewer initial PIMs and were less likely to refill a PIM after an outpatient visit than physicians. The lower odds of receiving PIMs during an NP visit varied by age, race/ethnicity, rurality, and number of comorbidities.
(© 2021 The American Geriatrics Society.)

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