Describing Nurse Practitioners' Prescription Billings for Residents Living in Long-Term Care in Ontario, Canada: A Descriptive Time Trend Study

OBJECTIVES: To examine the prescribing patterns of nurse practitioners (NPs) caring for residents living in long-term care (LTC) homes over time and by resident- and facility-level factors. DESIGN: A descriptive time trend study was conducted using linked administrative data from Ontario between 2014 and 2024. SETTING AND PARTICIPANTS: All prescription claims for residents living in LTC homes in Ontario. METHODS: Descriptive statistics summarized prescribing volumes, medication classes, and resident- and facility-level characteristics for each year. RESULTS: There was a total of 8,720,276 NP prescriptions during the study period. The proportion of prescription billings by NPs increased from 0.92% in 2014 to 6.15% in 2024. Variations were observed by rurality and facility size. The increase in the proportions of NP prescriptions was greater for residents in rural homes (from 0.74% in 2014 to 13.31% in 2024) than for those in urban settings. The increase in the proportion of NP prescriptions was greater in smaller homes (from 0.63% in 2014 to 7.24% in 2024) compared with medium and larger homes. CONCLUSIONS AND IMPLICATIONS: This study was the first population-level analysis of NP prescribing in Ontario for LTC residents. Findings underscore the evolving contribution of NPs to medication management and reinforce the need for policies that optimize their role in improving quality of care for LTC residents.