This study aimed to compare patient outcomes between prescribing psychologists, psychiatrists, and primary care physicians (PCPs). Private insurance claims (2005-2021; n = 307,478) were used to conduct an active comparator, new user longitudinal cohort study developed using target trial emulation. Inverse propensity for treatment weighting was used to adjust for baseline differences in a range of sociodemographic, clinical, and contextual patient factors. Differences in the 1-year rate of health care visits for adverse drug events (ADEs), psychiatric emergency department (ED) utilization, medication adherence, and psychotropic polypharmacy were identified between prescribing psychologists and the other provider types using doubly robust Cox proportional hazards models. Compared to patients of psychiatrists, patients of prescribing psychologists had a 24% lower rate of ADEs (95% CI [0.60, 0.96]), a 20% lower rate of psychotropic polypharmacy (95% CI [0.74, 0.86]), and similar rates of psychiatric ED utilization and medication nonadherence. Compared to patients of PCPs, patients of prescribing psychologists had 138% higher rates of psychiatric ED utilization (95% CI [1.67, 3.39]), 175% higher rates of psychotropic polypharmacy (95% CI [2.53, 2.99]), 28% lower rates of medication nonadherence (95% CI [0.66, 0.78]), and similar rates of ADEs. Using robust pharmacoepidemiological methods, we noted that among mental health specialists, prescribing psychologists appear to be as safe and efficacious as psychiatrists in a large sample of privately insured patients. Notable differences in safety and efficacy when compared to PCPs may be attributable to differences between specialty and primary care. Future research on prescribing psychologists should move toward studies of care quality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

---

评估新墨西哥州和路易斯安那州心理学家开处方的安全性和有效性。


本研究旨在比较心理学家、精神科医生和初级保健医生 (PCP) 开处方时的患者治疗结果。私人保险索赔（2005-2021 年；n = 307,478）用于进行主动比较，即使用目标试验模拟开发的新用户纵向队列研究。治疗权重的逆倾向用于调整一系列社会人口统计学、临床和患者背景因素的基线差异。使用双稳健 Cox 比例风险模型，确定了开处方的心理学家和其他类型的提供者之间因药物不良事件 (ADE)、精神科急诊科 (ED) 使用率、药物依从性和精神药物多药治疗而进行的 1 年就诊率的差异。与精神科医师开药的患者相比，心理科医师开药的患者的 ADE 发生率低 24%（95% CI [0.60, 0.96]），精神科多药用药率低 20%（95% CI [0.74, 0.86]），并且相似精神科 ED 使用率和药物不依从率。与 PCP 患者相比，心理医生开处方的患者的精神科 ED 使用率高出 138%（95% CI [1.67, 3.39]），精神科多重用药率高出 175%（95% CI [2.53, 2.99]），28%药物不依从率较低（95% CI [0.66, 0.78]），不良事件发生率相似。使用强大的药物流行病学方法，我们注意到，在心理健康专家中，心理学家在大量私人保险患者样本中开出处方似乎与精神科医生一样安全有效。与 PCP 相比，安全性和有效性的显着差异可能归因于专业护理和初级护理之间的差异。 未来对心理学家处方的研究应该转向护理质量的研究。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。