Can Dietitians Prescribe Medications?

Can a Dietitian Prescribe Medications?

No, in most countries, a registered dietitian nutritionist (RDN) cannot prescribe any medications. While they are healthcare professionals, dietitians are not physicians.

Who Can Write Prescriptions for Medications?

In earlier history, only physicians could prescribe medications. However, now there are several healthcare provider types that can prescribe. In the United States, this generally includes:

  • Physicians (MDs and DOs)
  • Nurse practitioners
  • Physician assistants
  • Certified registered nurse anesthetists
  • Clinical nurse specialists
  • Certified nurse-midwives

The specifics of what provider types can prescribe, what types of medications they can prescribe and if supervision by a doctor is required, can vary widely, as it depends on both federal and state law. The scope of practice of pharmacists has also expanded so under certain circumstances, they may be able to prescribe as well. 

Note that many allied healthcare providers such as registered dietitians, physical therapists, occupational therapists and speech pathologists, do not have prescriptive authority. This does not mean that they are not a valuable part of the healthcare team, however. Medication is simply one piece of healthcare overall. 

Dietitian Scope of Practice Regarding Medication Adjustments

While dietitians in the United States cannot directly prescribe medication, they can potentially initiate and adjust medications that are nutrition-related. This can make a dietitian’s services much more comprehensive. For example, if a dietitian specializing in diabetes is working with a patient, it may make sense to discuss nutrition and also adjust insulin doses during the same appointment. 

Based on the Academy of Nutrition and Dietetics (AND) Scope and Standards of Practice, dietitians can make these types of adjustments if they have the competency and the organization that they work for have policies and procedures to support this. 

Specifically, AND states dietitians can “initiate, implement and adjust” medication orders that are “protocol- or physician-order-driven.” This must be “in accordance with clinical privileges, delegated orders, or protocols consistent with organization policy and procedure.”

Dietitians Prescribing in the United Kingdom 

Dietitians have had supplementary prescribing rights in the UK since 2016. This means they can prescribe when there is a partnership with an independent prescriber and there is a clinical management plan (CMP) in place. This CMP is patient-specific and has distinct parameters. 

Dietitians that are supplementary prescribers can write scripts for nutrition-related medications such as:

  • Parenteral nutrition
  • IV fluids and electrolytes
  • Vitamins – intravenous, intramuscular and oral
  • Insulin
  • Antibiotics
  • Antiemetics
  • Proton pump inhibitors
  • Laxatives
  • Pancreatic enzyme replacement therapy

There is also a campaign called Prescribe Now!, aimed to give allied health professionals independent prescribing rights in the UK, so they would have autonomy. This would include dietitians, occupational therapists, radiographers as well as other medical professionals.

Summary

In most countries, dietitians cannot prescribe medication. There are some situations in which dietitians can start or adjust medications based on specific protocols and procedures. However, the name of a physician or other healthcare professional would need to be on the script for the pharmacy to accept it. 

References:

Practitioners And Prescriptive Authority

Scope of Practice

Revised 2024 Scope and Standards of Practice for the Registered Dietitian Nutritionist

CASE STUDY – RDNs in Diabetes Education and Care Plan Management that Includes Medication Adjustments

What are dietitians prescribing? An evaluation of the prescribing practice of a nutrition support dietitian

Dietitian Prescribing: More than just supplements

Independent Prescribing

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