Understanding Advanced Practitioner Prescriptive Privileges for Anticancer Therapies: A National Survey

Abstract

Oncology advanced practitioners (APs) work in collaboration with physicians to provide high-quality, specialized oncology care. Data are lacking on individual AP function within different practice settings, specifically around the prescribing of anticancer therapies. Our primary aim was to conduct a prospective, national, web-based survey to understand AP roles in prescribing anticancer therapies and the related privileging process(es) in both academic and community oncology practice settings. A 38-question survey was developed based on a review of published oncology AP data sets, expert input, and cognitive interviews with key AP informants. Survey domains included basic respondent demographics, practice setting information, and prescribing and privileging practices. The survey was distributed by the Association of Community Cancer Centers (ACCC) and the Advanced Practitioner Society for Hematology and Oncology (APSHO) in late 2022. 180 individuals responded, and 135 oncology APs completed the survey. The majority of respondents practice in states that allow prescriptive privileging for anticancer therapies. Only half of those that have prescriptive privileging have an established privileging and competency process at their practice setting. Among the nurse practitioners and physician assistants practicing in primarily independent roles, only about half can prescribe both standard-of-care and investigational therapies. This national survey provides valuable insights into the prescribing practices of oncology APs. The findings highlight the need to further develop standardized privileging and competency strategies within the AP community. By addressing these gaps, APs can play a crucial role in addressing workforce shortages in oncology and optimizing patient outcomes.