Pharmacist independent prescribing in secondary care: opportunities and challenges
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In recent years a number of countries have extended prescribing rights to pharmacists in a variety of formats. The latter includes independent prescribing, which is a developing area of practice for pharmacists in secondary care. Potential opportunities presented by wide scale implementation of pharmacist prescribing in secondary care include improved prescribing safety, more efficient pharmacist medication reviews, increased scope of practice with greater pharmacist integration into acute patient care pathways and enhanced professional or job satisfaction. However, notable challenges remain and these need to be acknowledged and addressed if a pharmacist prescribing is to develop sufficiently within developing healthcare systems. These barriers can be broadly categorised as lack of support (financial and time resources), medical staff acceptance and the pharmacy profession itself (adoption, implementation strategy, research resources, second pharmacist clinical check). Larger multicentre studies that investigate the contribution of hospital-based pharmacist prescribers to medicines optimisation and patient-related outcomes are still needed. Furthermore, a strategic approach from the pharmacy profession and leadership is required to ensure that pharmacist prescribers are fully integrated into future healthcare service and workforce strategies.
KeywordsSecondary care Independent prescribing Medicines optimisation Professional practice United Kingdom
Conflicts of interest
- 4.Phelps A, Agur M, Nass L, Blake M. GPhC Registrant Survey 2013. General Pharmaceutical Council 2014. http://www.pharmacyregulation.org/sites/default/files/gphc_registrant_survey_2013_main_report_by_natcen.pdf. Accessed 10 Nov 2015.
- 5.Hinchliffe A. Pharmacist independent prescribing-a review of the evidence. NHS Wales 2015. https://www2.nphs.wales.nhs.uk/PharmaceuticalPHTDocs.nsf/($All)/45E9469550B09BB280257DF6004058CE/$File/Pharmacist%20independent%20prescribingv1.1.pdf?OpenElement. Accessed 27 Aug 2015.
- 9.Tsuyuki R, Houle S, Charrois T, Kolber M, Rosenthal M, Lewanczuk R, et al. A randomized trial of the effect of pharmacist prescribing on improving blood pressure in the community: the Alberta clinical trial in optimizing hypertension (RxACTION). Circulation. 2015;132:93–100.CrossRefPubMedGoogle Scholar
- 10.Health Education England. Investing in people for health and healthcare. Workforce plan for England. Proposed education and training commisions for 2014–15. 2014. http://hee.nhs.uk/wp-content/uploads/sites/321/2013/12/Workforce-plan-investing-in-people.pdf. Accessed 27 Aug 2015.
- 11.Scottish Government Department of Health and Wellbeing. Prescription for excellence: a vision and action plan for the right pharmaceutical care through integrated partnerships and innovation. 2013. http://www.gov.scot/resource/0043/00434053.pdf. Accessed 27 Aug 2015.
- 13.National Institute for Health and Care Excellence. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. 2015. https://www.nice.org.uk/guidance/ng5. Accessed 27 Aug 2015.
- 14.Dornan T, Ashcroft D, Heathfield H, Lewis P, Miles J, Taylor D, et al. An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study. General Medical Council, 2009. http://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdf. Accessed 27 Aug 2015.
- 20.Onatade R, Al-Azeib S, Gore S. Description and evaluation of the quality of pharmacist-written discharge medication. Int J Pharm Pract. 2014;22(S2):82–83.Google Scholar
- 27.Royal Pharmaceutical Society. Improving Urgent and Emergency Care through better use of pharmacists. 2014. http://www.rpharms.com/policy-pdfs/urgent-and-emergency-care.pdf. Accessed 27 Aug 2015.
- 30.Hassell K. GPhC Register Analysis 2011. Centre for Pharmacy Workforce Studies 2012. http://www.pharmacyregulation.org/sites/default/files/Analysis%20of%20GPhC%20Pharmacist%20Register%202011.pdf. Accessed 10 Nov 2015.
- 31.Buckley P, Grime J, Blenkinsopp A. Inter-and intra-professional perspectives on non-medical prescribing in an NHS trust. Pharm J. 2006;277:394–8.Google Scholar
- 32.Royal Pharmaceutical Society. Medicines Optimisation: Helping patients to make the most of medicines. 2013. https://www.rpharms.com/promoting-pharmacy-pdfs/helping-patients-make-the-most-of-their-medicines.pdf. Accessed 27 Aug 2015.
- 35.Medical Education England. Modernising Pharmacy Careers programme. Pharmacist Prescriber Training Working Group Report. 2010. http://hee.nhs.uk/healtheducationengland/files/2012/10/Pharmacist-Prescriber-Training-Report-for-MPC.pdf. Accessed 27 Aug 2015.
- 37.Royal Pharmaceutical Society. Professional Standards for Hospital Pharmacy Services. Optimising Patient Outcomes from Medicines. 2014. http://www.rpharms.com/support-pdfs/rps—professional-standards-for-hospital-pharmacy.pdf. Accessed 27 Aug 2015.