Scope-of-Practice for Nurse Practitioners and Adherence to Medications for Chronic Illness in Primary Care


Ulrike Muench, Christopher Whaley, Janet Coffman, and Joanne Spetz

June 24, 2020

Nonadherence to medications is costly and improving adherence is difficult, requiring multifactorial solutions, including policy solutions. The purpose of this study was to evaluate the effect of one policy strategy on medication adherence. Specifically, we examined the effect on adherence of expanding scope-of-practice regulations for nurse practitioners (NPs) to practice and prescribe without physician supervision. We conducted three difference-in-difference multivariable analyses of commercial insurance claims. Our results indicate that scope-of-practice regulations that allow NPs to practice and prescribe without physician oversight are associated with improved medication adherence. We postulate that the mechanism for this effect is increased access to health care services, which in turn increases access to prescriptions. Our results suggest that policies allowing NPs to maximally use their skills can be beneficial to patients.