Comparing Nurse Practitioner and General Practitioner error rates in a digital health setting

Do error rates actually differ between nurse practitioners and general practitioners?

A new study published in Nursing Reports has revealed that nurse practitioners (NPs) can prescribe medications as safely as general practitioners (GPs) in a large digital health service setting. In the context of the recent debates over expanding NP prescribing responsibilities in Australia, the study provides crucial data on NP prescribing safety in one of Australia’s largest digital health companies, Eucalyptus. The study revealed insights that the error rate difference was not statistically significant.

NPs demonstrated a lower overall prescribing error rate (14.22%) compared to GPs (21.37%)

Are nurse practitioners able to prescribe safely?

The safety of NP prescribing has been seriously questioned since the Australian government removed the NP collaborative arrangement requirement for prescribing medications in early 2024. Criticisms of the decision centred around the argument that NP prescribing, in general, increases the risk of patient harm. However, prior to this study, no quantitative comparisons of NP and GP prescribing safety had been conducted in any Australian care setting, let alone a modern digital care context. Australian research on NP prescribing had only been conducted in areas such as regulatory issues, liability concerns, employee characteristics, and cost-benefit analyses.

The study reviewed 8,359 patient consultations conducted by Eucalyptus practitioners between October 2023 and March 2024. Of these, 6,408 consultations were led by NPs and 1,951 by GPs. Prescribing errors were identified and rated low-, medium-, or high risk, or "never events" that could result in death or permanent harm.

The findings demonstrated that prescribing error rates were actually lower for NPs than for GPs (difference was not statistically significant), with NPs demonstrating a lower overall prescribing error rate (14.22%) compared to GPs (21.37%), and most errors falling into low- and medium-risk categories.

When looking at severe errors, there was no significant difference between NPs and GPs for high-risk or “never event” errors, indicating comparable safety for the most critical aspects of prescribing.

Significance of this research

These results indicate that NPs can safely perform assessments and prescribe medications for various chronic conditions in digital health settings, and are well-equipped to handle prescribing responsibilities within their scope, without compromising patient safety.

The findings provide further evidence supporting the recent policy changes allowing NPs greater independence in prescribing, which aims to alleviate pressure on Australia’s GP workforce and improve access to healthcare, especially in underserved areas.

To read more about how nurse practitioners play a role in healthcare, read more in our blog.