A Study of Expanding Prescriptive Authority for Controlled Substances to Advanced Registered Nurse P...
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A Study of Expanding Prescriptive Authority for Controlled Substances to Advanced Registered Nurse Practitioners 2004 HB 595. Barbara Baker John Perry. Purpose of the Study. Discuss the potential positive and negative effects of authorizing ARNPs to prescribe controlled substances in Kentucky

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Barbara baker john perry

A Study of Expanding Prescriptive Authority for Controlled Substances to Advanced Registered Nurse Practitioners

2004 HB 595

Barbara Baker

John Perry


Purpose of the study

Purpose of the Study

  • Discuss the potential positive and negative effects of authorizing ARNPs to prescribe controlled substances in Kentucky

    • Review research literature

  • Describe ARNP education relevant to prescribing controlled substances in Kentucky

    • Review and compare pharmacology curriculum for physicians and ARNPs at UK and UofL

  • Gather opinions of interested and affected parties

    • Surveys and interviews

  • Evaluate relationship between the quantity of controlled substances and ARNPs authority

    • Data from U.S. DEA and Verispan

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Categories of prescription drugs

Schedule Examples

I Heroin

II OxyContin

III Tylenol with codeine

IV Valium

V Cough syrups

Categories of Prescription Drugs

Nonscheduled

Drugs Examples

Antibiotics Penicillin

Antihistamines Allegra

Cholesterol Lipitor

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Findings

Findings

  • Little research has been performed specifically examining the effects of ARNPs prescribing controlled substances

  • Physician and ARNP pharmacology courses at UK and UofL include similar content and time related to controlled substances

    • Physicians may have more time in clinical practice

  • Most states allow ARNPs to write controlled substance prescriptions

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Findings status of arnp controlled substance prescribing

All states and DC currently authorize ARNPs to prescribe all medicines except for controlled substances

44 states and DC grant expanded authority for controlled substances

36 states allow prescribing of Schedules II through V

8 states grant full authority

28 states grant authority with various limitations

Kentucky is among the six states that do not allow ARNPs to prescribe controlled substances

No authorization in 6 states: AL, FL, HI, MO, KY, and GA

Findings: Status of ARNP Controlled Substance Prescribing

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Comments of interested parties

Proponents

Improve access to health care

Increase autonomy

Increase accountability

Opponents

Portal for drug diversion

Question educational qualifications

Patient safety concerns

Comments of Interested Parties

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Findings practitioner surveys

Findings: Practitioner Surveys

  • ARNPs largely support being granted authority while physicians are generally opposed

    ResponseARNP Physician

    Yes, no limitations 60% 4%

    Yes, with limitations 36% 27%

    No 3% 68%

    No Opinion 1% 1%

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Findings practitioner surveys1

Findings: Practitioner Surveys

  • Some agreement between physicians and ARNPs on limitations to authority if limitations are enacted

    LimitationARNP Physician

    Collaborative agreement include

    specific classes of substances 64% 97%

    Submit collaborative agreement

    to Board of Nursing 70% 90%

    Collaborating physician must

    review ARNP regularly 61% 99%

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Findings data analysis

Findings: Data Analysis

Effect on Number of Prescriptions

Schedule II 1.4% increase per year

Schedule III6.4% total increase

Schedule IVno effect

  • There is evidence that states where ARNPs can prescribe controlled substances have larger per capita quantities than states where they cannot

Effect on Quantity in Grams

Schedule II6.6% increase per year

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Barbara baker john perry

A Study of Expanding Prescriptive Authority for Controlled Substances to Advanced Registered Nurse Practitioners

2004 HB 595


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