Prescribing Patterns of Gerontological Nurse Practitioners in the United States

This presentation is part of : Gerontological Nursing

Laurie Kennedy-Malone, PhD, APRN, BC, School of Nursing, The University of North Carolina at Greensboro, Greensboro, NC, USA and Mary Fleming, MSN, APRN, BC, Public Health Service, Federal Correctionional Institute- Butner North Carolina, Butner, NC, USA.

Design: A descriptive survey design was used to discern the prescribing patterns of GNPs in the United States.

Population: The target population for this study consisted of 3,456 American Nurses Credentialing Center certified GNPs from which a random sample of 1000 certified GNPs was selected. The Gerontological Nurse Practitioner Practice Profile developed by the author, was mailed to selected participants; reminder cards were sent to non-responding subjects. The survey was mailed in July, 2002. A 47.5% response rate was obtained.

Concepts: The Gerontological Nurse Practitioner Profile (GNPP) is a 45 item instrument that consists of six sections. Sections of the instrument pertain to educational preparation and practice characteristics of GNPs. The final section list 23 groups of medications; each subject was asked to indicate how often they prescribed each medication category.

Methods: The GNPP and a cover letter were mailed along with a stamped return envelope. Upon return, all questionnaires were reviewed to determine appropriateness for inclusion. For this paper, a subset of those working 35 hours a week or more as GNPs were included for final analysis.

Findings: There were 254 surveys utilized for this smaller study. The majority of the respondents were Caucasian females with a mean age of 46. The GNPs work predominately in urban settings. GNPs indicated that analgesics were the category of medications most prescribed followed by medications targeted for chronic diseases such as hypertension and diabetes.

Conclusions: The self-reported rankings of medications prescribed by GNPs indicate the chronicity and complex medication regimens of older adults.

Implications: Given the complexity of medication regimens for older adults, further research is warranted to determine if GNPs are prescribing appropriately, considering the updated Beers criteria (2003) for inapproriate medication for older adults.

Learning Objective #1: Describe the prescribing practices of gerontological nurse practitioners in the United States
Learning Objective #2: Identify implications for further research on gerontological nurse practitioner prescribing practices as they pertain to appropriateness of medications for older adults