title: The effects of nurse prescribing: a systematic review.
abstract: BACKGROUND
  In 2008, we conducted a systematic review on the effects of nurse prescribing using studies with a comparative design. In view of the growing number of countries that are introducing nurse prescribing and the fact that several studies into nurse prescribing have been conducted recently, there is a need for an updated review to reassess the available information on the effects of nurse prescribing when compared to physician prescribing.
  
  
  OBJECTIVE
  To identify, appraise and synthesise the evidence on the effects of nurse prescribing when compared to physician prescribing on the quantity and types of medication prescribed and on patient outcomes.
  
  
  METHODS
  A systematic review.
  
  
  METHODS
  In addition to the previous review, which covered the literature up to 2005, 11 literature databases and four websites were searched for relevant studies from January 2006 up to January 2012 without limitations as to language or country. Moreover, full-text copies of all studies included in the previous review were reviewed.
  
  
  METHODS
  A three-stage inclusion process, consisting of an initial sifting, checking full-text papers for inclusion criteria and methodological assessment, was performed independently by two reviewers. Data on effects were synthesised using narrative and tabular methods.
  
  
  RESULTS
  Thirty-five studies met the inclusion criteria. All but five studies had a high risk of bias. Nurses prescribe in comparable ways to physicians. They prescribe for equal numbers of patients and prescribe comparable types and doses of medicines. Studies comparing the total amount of medication prescribed by nurses and doctors show mixed results. There appear to be few differences between nurses and physicians in patient health outcomes: clinical parameters were the same or better for treatment by nurses, perceived quality of care was similar or better and patients treated by nurses were just as satisfied or more satisfied.
  
  
  CONCLUSIONS
  The effects of nurse prescribing on medication and patient outcomes seem positive when compared to physician prescribing. However, conclusions must remain tentative due to methodological weaknesses in this body of research. More randomised controlled designs in the field of nurse prescribing are required for definitive conclusions about the effects of nurse prescribing.
authors.affiliation: Institute of Nursing Studies of HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: Sanne C
authors.initials: SC
authors.lastname: Gielen
authors.affiliation: Department of Neonatology of LUMC, Leiden, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Dekker
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Department of Public and Occupational Health, EMGO Institute for Health and Care Research (EMGO+) of VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Patriek
authors.initials: P
authors.lastname: Mistiaen
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. Electronic address: M.Kroezen@nivel.nl.
authors.forename: Marieke
authors.initials: M
authors.lastname: Kroezen
mesh_terms: D011307:Drug Prescriptions; D006801:Humans; D017060:Patient Satisfaction; D057184:Practice Patterns, Nurses'; D011787:Quality of Health Care
keywords: Drug prescriptions; Nurse practitioners; Nurses; Physicians; Review; Systematic