The Advanced Practice Registered Nurse as a Prescriber. Группа авторов
Other special considerations
An employer or health system may restrict APRN prescribing more than the law does. The VA and health maintenance organizations such as Kaiser Permanente use preferred drug lists, or formularies, to promote evidence‐based prescribing and control costs. Similarly, Medicaid and Medicare set guidelines for drug benefits, while private health plans usually have different tiers of drug coverage to promote prescribing of effective lowest cost drugs.
Pharmacy benefit managers are another aspect of the medication distribution chain, negotiating with drug companies and pharmacies on behalf of health plans. They develop formularies on behalf of the health plans, negotiate discounts and rebates with the manufacturers, and contract with pharmacies to reimburse for drugs dispensed to health plan beneficiaries (Commonwealth Fund, 2019). Some retailers have drugs dispensed for reduced costs, such as a $4 or $10 prescription, or offer reduced rates based on membership (Torrey, 2019). Discount coupons are often available from the manufacturer for some high‐cost medications or discount programs.
THE FUTURE OF THE APRN PRESCRIBING ROLE
The US opioid epidemic, increasing antibiotic resistance, the escalating costs of prescription drugs, and limited access to medication in under resourced countries are a few examples of why rational prescribing is imperative. A balance between pharmacological and non‐pharmacological treatment options is becoming increasingly desirable as many patients use herbal remedies and supplements and seek more holistic healing approaches, choosing to avoid medication risks and side effects. New scientific information may also reveal additional considerations about medication safety or sequelae. The APRN has the opportunity to meet these demands using evidence‐based practices and rational prescribing. As the evidence base for pharmacological treatment changes and the use of electronic prescribing increases, the APRN must adapt prescribing practices. Adoption of the prescriber role is a career‐long process that requires vigilance and wisdom.
REFERENCES
1 Abramson, E. (2015). Causes and consequences of e‐prescribing errors in community pharmacies. Integrated Pharmacy Research and Practice, 4(5), 31–38.
2 Agency for Healthcare Research and Quality. (2020) Medication errors and adverse drug events. Retrieved from https://psnet.ahrq.gov/primer/medication‐errors‐and‐adverse‐drug‐events. (Accessed 7 September 2020.)
3 Alabama State Board of Nursing. (2020). Nurse Practice Act Article 5, Advanced Practice Nursing §34‐21‐86. Retrieved from https://www.abn.alabama.gov/wp‐content/uploads/2016/02/nursing‐practice‐act‐article‐5.pdf. (Accessed 7 September 2020.)
4 Alex, S., Adenew, A.B., Arundel, C., et al. (2016). Medication errors despite using electronic health records: The value of a clinical pharmacist service in reducing discharge‐related medication errors. Quality Management in Health Care, 25(1), 32–37.
5 Blanco‐Reina, E., Arixza‐Zafra, G., Ocana‐Ricola, R., & Leon‐Ortiz, M. (2014). 2012 American Geriatrics Society Beers Criteria: Enhanced applicability for detecting potentially inappropriate medications in European older adults? A comparison with the Screening Tool of Older Person’s Potentially Inappropriate Prescriptions. Journal of the American Geriatric Society, 62(7), 1217–1223.
6 Brown, S.A., & Grimes, D.E. (1995). A meta‐analysis of nurse practitioners and nurse midwives in primary care. Nursing Research, 44(6), 332–339.
7 Brown, M.A., & Olshansky, E. (1998). Becoming a primary care nurse practitioner: Challenges of the initial year of practice. Nurse Practitioner, 23(7), 46, 52–56, 58.
8 Brykcznski, K.A. (2019). Role development of the advanced practice nurse. In M.F. Tracy & E.T. O’Grady (Eds), Hamric and Hanson’s advanced practice nursing: an integrative approach (6th ed., pp. 80–108). St. Louis, MO: Saunders Elsevier Health Sciences.
9 Code of Colorado Regulations. (2017). Board of nursing. 3CCR 716‐1. (1.15) rules and regulations for prescriptive authority for advanced practice registered nurses. Retrieved from https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=9035&fileName=3%20CCR%20716‐1. (Accessed 2 November 2020.)
10 Commonwealth Fund. (2019). Pharmacy benefit managers and their role ion drug spending. Retrieved from https://www.commonwealthfund.org/publications/explainer/2019/apr/pharmacy‐benefit‐managers‐and‐their‐role‐drug‐spending. (Accessed 7 September 2020.)
11 Congressional Budget Office. (1979). Physician extenders: Their current and future role in medical care delivery. Washington, DC: US Government Printing Office.
12 DeFrank, J.T., Berkman, N.D., Kahwathi, L., et al. (2019). Direct‐to‐consumer advertising of prescription drugs and the patient–prescriber encounter: A systematic review. Health Communication, 35(6), 739–146.
13 DesRoches, C.M., Clarke, S., Perloff, J., et al. (2017). The quality of primary care provided by nurse practitioners to vulnerable Medicare beneficiaries. Nursing Outlook, 65(6), 679–688.
14 Dulisse, B., & Cromwell, J. (2010). No harm found when nurse anesthetists work without supervision by physicians. Health Affairs, 29(8), 1469–1475.
15 Dunphy, L.M. (2018). Advanced practice nursing: Doing what has to be done. In L. Joel (Ed.), Advanced practice nursing: Essentials for role development (pp. 2–16). Philadelphia: F.A. Davis.
16 Farrell, V.M., Hill, V.L., Hawkins, J.B., et al. (2003). Clinic for identifying and addressing polypharmacy. American Journal of Health‐System Pharmacy, 60(18), 1834–1835.
17 Fick, D.M., Cooper, J.W., Wade, W.E., et al. (2003). Updating the Beers Criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Archives of Internal Medicine, 163(22), 2716–2724.
18 Filipova, A. (2019). Relationship of direct‐to‐consumer advertising to efficiency of care, quality of care and health outcomes. Journal for Healthcare Quality, 42(3), e18–e31.
19 Fletcher, C.E., Baker, S.J., Copeland, L.A., et al. (2007). Nurse practitioners’ and physicians’ views of NPs as providers of primary care to veterans. Journal of Nursing Scholarship, 39(4), 358–362.
20 Fulton, M.M., & Allen, E.R. (2005). Polypharmacy in the elderly: A literature review. Journal of the American Academy of Nurse Practitioners, 17(4), 123–132.
21 Garzon Maaks, D.L., Starr, N.B., Brady, M.A., et al. (2020). Burns’ pediatric primary care (7th ed.). St. Louis, MO: Elsevier.
22 Grace, P.J. (2009). Nursing ethics and professional responsibility in advanced practice. Sudbury, MA: Jones & Bartlett.
23 Horrocks, S., Anderson, E., & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. British Medical Journal, 324(7341), 819–823.
24 Jennings, N., Clifford, S., Fox, A.R., et al. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International Journal of Nursing Studies 52(1), 421–435.
25 Jones, L.K., Ladd, I.G., Gregor, C., et al. (2019). Understanding the medication prior‐authorization process: A case study of patients and clinical staff from a large rural integrated health delivery system. American Journal of Health Systems Pharmacy, 76(7), 453–459.
26 Kaplan, L., & Brown, M.A. (2004). Prescriptive authority and barriers to NP