Open AccessThe Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill
Author(s) -
Thủy Nguyễn,
Ulrike Muench,
Barbara AndrakaChristou,
Kosali Simon,
W. David Bradford,
Joanne Spetz
Publication year - 2021
Publication title -
medical care research and review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.433
H-Index - 85
eISSN - 1552-6801
pISSN - 1077-5587
DOI - 10.1177/10775587211004311
Subject(s) - buprenorphine , medicine , medical prescription , pharmacy , scope of practice , scope (computer science) , nurse practitioners , family medicine , methadone , opioid epidemic , medline , opioid , nursing , psychiatry , health care , political science , law , receptor , computer science , programming language
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.