Stakeholders’ views on granting prescribing authority to pharmacists in Nigeria: a qualitative study
- 219 Downloads
Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients’ access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders’ views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders’ perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients’ access to medicines, reduce doctors’ workload and promote the utilisation of pharmacists’ skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists’ inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all stakeholders acknowledged the potential of pharmacist prescribing to increase patients’ access to medicines in Nigeria.
KeywordsAccess to medicines Nigeria Patient representatives Pharmacists Pharmacist prescribing Physicians Policymakers
The authors would like to thank all participants for their valuable time and contributions to this research.
No financial support was obtained for this study.
Conflicts of interest
The authors do not have any conflict of interest to declare.
- 1.Review of prescribing, supply & administration of medicines. Final report. 1999. http://webarchive.nationalarchives.gov.uk/20130107105354/ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4077153.pdf. Accessed 30 Mar 2016.
- 5.Tonna AP, Stewart D, McCaig D. An international overview of some pharmacist prescribing models. J Malta Coll Pharm Pract. 2008;14:20–6.Google Scholar
- 6.Pharmacy Council of New Zealand. Pharmacist Prescribers. http://www.pharmacycouncil.org.nz/cms_display.php?st=1&sn=232. Accessed 30 Mar 2016.
- 8.Nissen L. Hospital talk: pharmacist prescribing-the perfect storm? Aust J Pharm. 2014;95:29.Google Scholar
- 9.National Drug Policy-Nigeria. Abuja: Federal Ministry of Health, Nigeria and World Health Organisation; 2005. http://apps.who.int/medicinedocs/documents/s16450e/s16450e.pdf. Accessed 30 Mar 2016.
- 11.Access to and rational use of medicines at the facility level. Abuja: Federal Ministry of Health, Nigeria; 2010.Google Scholar
- 12.Babalola CP, Awoleye SA, Akinyemi JO, Kotila OA. Evaluation of prescription pattern in Osun State (Southwest) Nigeria. J Public Health Epidemiol. 2011;3(3):94–8.Google Scholar
- 14.Akande T. Referral system in Nigeria: study of a tertiary health facility. Ann Afr Med. 2004;3(3):130–3.Google Scholar
- 16.Umar I, Oche MO, Umar AS. Patient waiting time in a tertiary health institution in Northern Nigeria. J Public Health Epidemiol. 2011;3(2):78–82.Google Scholar
- 18.World Bank. Physicians (per 1000 people). http://data.worldbank.org/indicator/SH.MED.PHYS.ZS. Accessed 30 Mar 2016.
- 19.Oche M, Adamu H. Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria. Ann Med Health Sci Res. 2014;3(4):588–92.Google Scholar
- 21.WAPCP Listing of fellows of the college (1991–2011). http://www.wapcp.info/sites/default/files/news_attachments/wapcp_listing_of_fellows1991-2011.pdf. Accessed 1 Feb 2013.
- 23.Erhun WO, Osigbesan T, Awogbemi JK. Study of pharmacists’ and physicians’ views on pharmacists prescribing in Nigeria. West Afr J Pharm. 2013;24(2):76–82.Google Scholar
- 27.De Vries T, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing. A Practical Manual. Geneva: World Health Organization Action Programme on Essential Drugs; 1994.Google Scholar
- 29.Kondro W. Canada’s doctors assail pharmacist prescribing. CMAJ. 2007;177(6):558.Google Scholar
- 33.South African Pharmacy Council. Scope of practice and qualification for authorised pharmacist prescriber. Board Notice 122 of 2011. Government Gazette No. 34428.Google Scholar
- 36.Nigeria Demographic and Health Survey 2008. Abuja: National Population Commission and ORC Macro, 2009. http://www.dhsprogram.com/pubs/pdf/FR222/FR222.pdf. Accessed 30 Mar 2016.
- 39.World Health Organization. Nigeria still searching for right formula. 2015. http://www.who.int/bulletin/volumes/86/9/08-020908/en/. Accessed 22 June 2015.
- 40.Pharmacists Council of Nigeria. Full registration list of Pharmacists as at 2nd October, 2014. http://pcn.gov.ng/WEB%20full%20registration%20list.pdf. Accessed 11 Nov 2014.