High-Risk Opioid Prescribing and Nurse Practitioner Independence
Author Information
Author(s): Cusimano Lucas D. BS, Maestas Nicole MPP PhD
Primary Institution: Geisel School of Medicine at Dartmouth
Hypothesis
Were state policies that allowed nurse practitioners to work independently of physicians associated with rates of high-risk opioid prescribing?
Conclusion
The study found no association between legislation that granted independence to nurse practitioners and rates of risky opioid prescribing.
Supporting Evidence
- The estimated change in the rate of opioid prescriptions that overlapped with a CNS depressant was −0.03 per 100 members per month.
- Changes in the number of days of opioid-CNS depressant overlap and in the dosage and days supplied of opioids were also small and statistically insignificant.
- States that adopted NP independence legislation had similar demographic characteristics to nonadopting states.
Takeaway
The study looked at whether letting nurse practitioners work without doctors changed how often risky opioids were prescribed, and it found that it didn't.
Methodology
This was a difference-in-differences analysis comparing opioid prescribing rates in states that adopted nurse practitioner independence legislation with those that did not over a 24-month period.
Potential Biases
There may have been spillovers across states and legislative endogeneity affecting the results.
Limitations
The study may have selection bias due to the continuous enrollment requirement and potential legislative endogeneity.
Participant Demographics
Members aged 18 to 64 years with commercial insurance from Blue Cross Blue Shield.
Statistical Information
Confidence Interval
95% CI, −0.11 to 0.05
Digital Object Identifier (DOI)
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