Nursing prescription and reimbursement of nicotine replacement therapy in France
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Association Francophone des Infirmières en Tabacologie et Addictologie, Paris, France
Réseau de Prévention des Addictions, Paris, France
Publication date: 2020-10-22
Tob. Prev. Cessation 2020;6(Supplement):A57
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Since the law of 26 January 2016, occupational physicians, dental surgeons, nurses and physiotherapists, alongside doctors and midwives, are authorized to prescribe nicotine replacement therapy (NRT). Midwives have benefited from an extension of their prescription rights to those close to pregnant women. Since January 2020, NRT on prescription is reimbursed 100% for patients with long-term illness and 65% for others, but with the reimbursement of 35% of additional insurance. As a result, the smokers had nothing to pay, without time limitation. We analyze the consequences of these decisions.

Data from 2018 Health Insurance and a survey of nurses were analyzed.

According to National health insurance data, the number of non-physician prescribers increased from 2017 (4.8%) to 2018 (8%) (3.7% nurses), but non-physicians prescribed less: the 2706 nurses who prescribed NRT in 2018 made only 7235 prescriptions (2.7 prescriptions per nurse), but the number of nurse prescribers had more than doubled from 2017 to 2018.
According to the questionnaire-based survey initiated by the French Association of smoking cessation nurses (AFIT&A) to which 744 nurses replied, 63% know the regulations that authorize them to prescribe. Still, only 17% prescribe, (which is much more than in the general population of nurses, <1%), this is particularly true for nurses in addictology and tobacco centres. Many obstacles must be overcome to help the progression of NRT prescription by nurses: the need for training, access to hospital computer systems for prescription, and funding this new activity.

Following the new regulation that authorizes NRT prescription by nurses, the nurses’ prescriptions had double in 2018 compared to 2017, but remain marginal compared to NRT medical prescription.

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