Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
J Gen Intern Med. 2024 Nov;39(15):2935-2941. doi: 10.1007/s11606-024-08926-0. Epub 2024 Jul 16.
Although there is increased demand for behavioral health services, there is limited national data on the workforce prescribing psychotropics and/or medications for opioid use disorder (MOUD), and many current estimates are based on self-reported data or clinician rosters.
To describe trends in the workforce prescribing psychotropics (i.e., antidepressants, antipsychotics, antianxiety medications, mood stabilizers) and/or MOUD from 2017 to 2021.
Cross-sectional analysis of 2017-2021 IQVIA Xponent retail prescription claims data.
Clinicians who prescribed more than ten total prescriptions for psychotropics and/or MOUD in a calendar year.
We analyzed the number of prescriptions and prescribers by year, month, drug type, specialty type, payor type, and clinician county rurality.
There was a 2.7% increase in the number of prescribers between 2017 and 2021, with the highest growth among psychiatric nurse practitioners (44.7%), nurse practitioners (25.5%), and physician assistants (6.5%). Primary care physicians (PCPs) and advanced practice clinicians (APCs) made up more than half of the workforce but prescribed 3.5 times fewer prescriptions on average compared to psychiatric and addiction medicine specialists. PCPs and APCs in rural areas wrote the most prescriptions collectively for psychotropics and MOUD per month.
Using prescription data, a proxy for being active in the workforce, goes beyond specialty designation to identify the full workforce prescribing psychotropics and MOUD, including the growing role of APCs and PCPs.
尽管对行为健康服务的需求不断增加，但关于精神科药物处方和/或阿片类药物使用障碍（MOUD）药物处方的全国性数据有限，许多当前的估计是基于自我报告数据或临床医生名册。
描述 2017 年至 2021 年期间精神科药物（即抗抑郁药、抗精神病药、抗焦虑药、心境稳定剂）和/或 MOUD 处方者的趋势。
对 2017-2021 年 IQVIA Xponent 零售处方索赔数据进行横断面分析。
在一个日历年内开了超过十张精神科药物和/或 MOUD 总处方的临床医生。
我们按年、月、药物类型、专业类型、付款类型和临床医生县农村情况分析了处方数量和处方者。
2017 年至 2021 年间，处方者数量增加了 2.7%，其中精神科执业护士（44.7%）、执业护士（25.5%）和医师助理（6.5%）增长最快。初级保健医生（PCP）和高级实践临床医生（APC）占劳动力的一半以上，但平均处方数量比精神科和成瘾医学专家少 3.5 倍。农村地区的 PCP 和 APC 每月共同开出的精神科药物和 MOUD 处方数量最多。
使用处方数据（代表在劳动力中的活跃程度）可以超越专业指定，确定开精神科药物和 MOUD 处方的整个劳动力，包括 APC 和 PCP 的作用不断扩大。
