《2016 年阿片类药物法案后实践范围法规与护士从业者开处丁丙诺啡处方的关联性》
The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill.
机构信息
University of Michigan, Ann Arbor, MI, USA.
University of California, San Francisco, CA, USA.
出版信息
Med Care Res Rev. 2022 Apr;79(2):290-298. doi: 10.1177/10775587211004311. Epub 2021 Apr 1.
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.
本文利用 Optum 的匿名 Clinformatics Data Mart 中 2015 年 1 月至 2018 年 9 月的药房索赔数据，研究了联邦法规、州级执业护士（NP）范围法规与丁丙诺啡处方模式之间的关系。即使在 2016 年《全面成瘾和康复法案》（CARA）之后，以 NP 开具的处方的患者在县级的比例仍然很低，在不要求医生监督 NP 的州为 2.7%，在要求医生监督 NP 的州为 1.1%。虽然农村县的分析显示 NP 开具丁丙诺啡处方的比例较高，但仍相当低：规定限制较少的州为 3.7%，其他州为 1.1%。这些结果表明，更宽松的执业范围法规与 CARA 之后 NP 处方的增加有关。变化幅度较小表明，联邦通过 CARA 扩大治疗途径的尝试受到了限制。
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