For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Nurse prescribing, small numbers, but growing influence
Nurse prescribing, small numbers, but growing influence
New data presented by health analytics company Matui Ltd, using Ministry of Health Pharmaceutical Collection data, shows that medicines dispensed from nurse prescriptions grew 68% from 83,400 in 2019 to 1.4 million by 2021. Nurses also achieved higher rates of dispensing to Māori patients and those in areas of high deprivation than general practitioners.
Although nurse prescriptions made up only 3% of items dispensed in primary care, nurses and general practitioners prescribe a similar range of the most commonly used medicines and have similar patterns of prescribing when comparing items dispensed by age.
However, a higher proportion of prescriptions written by nurses were dispensed to Māori (21.20%) and to those living in areas of high deprivation (30.28%) compared to prescriptions written by general practitioners, where 14.65% of prescriptions were dispensed to Māori and 23.71% to those living in areas of high deprivation.
Nurses were more likely to have their prescriptions dispensed to women (60.85%) than general practitioners (52.24%).
Comparison of different types of nursing prescribing is not yet possible, as the Pharmaceutical Collection data does not currently identify different types of nurse prescribing.