An evaluation of mental health clinical pharmacist independent prescribers within general practice in remote and rural Scotland

  • Elizabeth BuistEmail author
  • Rebecca McLelland
  • Gordon F. Rushworth
  • Derek Stewart
  • Kathrine Gibson-Smith
  • Andrew MacLure
  • Scott Cunningham
  • Katie MacLure
Short Research Report


Background A 12-month pilot was implemented in two general practices in remote and rural Scotland, with patients referred by general practitioners to specialist mental health pharmacist independent prescribers. Objective The objective was to evaluate the pilot service from the perspectives of the patients and the care team. Methods The pharmacists routinely recorded patient-specific data of all clinical issues and their actions at the time of each consultation. Further datasets comprised baseline and follow-up Patient Health Questionnaire (PHQ-9) and/or Generalised Anxiety Disorder (GAD-7) rating scales, a patient survey and interviews with members of the care team. Results Of the 75 patients, two-thirds (n = 47, 62.7%) were referred with a diagnosis of mixed depression and anxiety. There were 324 consultations (median 3, IQR 2–5, range 1–14) and 181 prescribing actions. At pilot completion, 34 patients (45.3%) had PHQ-9 and/or GAD-7 scores reduced by 50%. Patient questionnaires and staff interviews generated positive responses. Conclusion This pilot has provided evidence that specialist mental health pharmacist independent prescribers delivered quality care to patients with diagnoses of moderate to severe depression and/or anxiety. Whilst accepting study limitations, there is potential to translate the pilot model of care to sustained services throughout general practice.


Anxiety disorders Depressive disorders Independent prescriber Pharmacist Primary care Research evaluation Scotland 



The authors would like to acknowledge all participants who took part in this pilot. We also thank Thom Shaw, Karen Macaskill, Michael Perera, general prcatitioners and practice staff at Glen Mor and Alness/Invergordon Medical Practices, Lochaber and Easter Ross; consultant psychiatrists and community mental health teams for their support and encouragement.


Funding for the pilot service was provided by the Scottish Government’s Primary Care Transformation Fund. Funding for the evaluation was provided by the Highland Pharmacy Education and Research Centre.

Conflicts of interest

The authors of the evaluation have no conflicts to declare.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Pharmacy DepartmentNew Craigs HospitalInvernessUK
  2. 2.Highland Pharmacy Education and Research CentreCentre for Health ScienceInvernessUK
  3. 3.School of Pharmacy and Life SciencesRobert Gordon UniversityAberdeenUK
  4. 4.College of Pharmacy, Qatar University HealthQatar UniversityDohaQatar

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