Developing and validating a tool for assessment of pharmacist prescribers' consultations (original) (raw)
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Learning to prescribe - pharmacists' experiences of supplementary prescribing training in England
BMC medical education, 2008
The introduction of non-medical prescribing for professions such as pharmacy and nursing in recent years offers additional responsibilities and opportunities but attendant training issues. In the UK and in contrast to some international models, becoming a non-medical prescriber involves the completion of an accredited training course offered by many higher education institutions, where the skills and knowledge necessary for prescribing are learnt. Aims: to explore pharmacists' perceptions and experiences of learning to prescribe on supplementary prescribing (SP) courses, particularly in relation to inter-professional learning, course content and subsequent use of prescribing in practice.
Pharmacy World & Science, 2008
Objective To investigate the challenges experienced by pharmacists in delivering supplementary prescribing (SP) services, to explore their perceptions of benefits of SP and to obtain feedback on both SP training and implementation. Method A postal questionnaire focusing on prescribing training, early experiences of prescribing and general demographics was sent in September to November 2005 to all SP pharmacists (n = 488) in Great Britain after excluding a pilot sample (n = 30). The biggest benefits and challenges of SP, and reasons for not practising SP, were identified. Responses to a general open question were content analysed for major themes. Key findings A total of 401 responses (82.2%) was received; 195 (48.6%) had started practising SP of which 154 (79%) had written at least one prescription. This paper focuses primarily on perceived benefits and challenges to the implementation of SP, and the responses to the open question. Better patient management (n = 58; 29.7%) was identified as the main benefit of SP and inadequate funding (n = 27; 13.8%) as the biggest challenge in delivering SP service. The main reasons for not commencing SP were: no organisational recognition of SP (n = 37; 18%); lack of funding (n = 33; 16%); non-availability of prescription pads (n = 22; 10.7%), and change of jobs (n = 18; 8.7%). The comments to the open question (n = 145; 36.2%) were regarding: SP training; perceived benefits of SP; and barriers to SP. Respondents highlighted the need for greater emphasis on clinical skills development as part of the SP course. Conclusion Despite optimism among SP pharmacists, the need for support in terms of infrastructure and integration into the healthcare team has been identified. Our findings also inform the need for modifications in the structure, content and delivery of the prescribing course for pharmacists. Greater publicity of pharmacists' roles in medication management, support from the medical profession and healthcare organisations, and high standards by early practitioners are warranted for the success of SP by pharmacists.
International Journal of Pharmacy Practice, 2010
Objectives Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary prescribers. Methods The setting was primary and secondary healthcare sectors in Northern Ireland. Pharmacists and mentors who had participated in a pre-training study were invited to take part. All pharmacists (n = 47) were invited to participate in focus groups, while mentors (n = 35) were asked to participate in face-to-face semi-structured interviews. The research took place between May 2005 and September 2007. All discussions and interviews were audiotaped, transcribed and analysed using constant comparison. Key findings Nine pharmacist focus groups were convened (number per group ranging from three to six; total n = 40) and 31 semi-structured interviews with mentors were conducted. The six main themes that emerged were optimal practice setting, professional progression for prescribing pharmacists, outcomes for prescribing pharmacists, mentors and patients, relationships, barriers to implementation and the future of pharmacist prescribing. Where practised, pharmacist prescribing had been accepted, worked best for chronic disease management, was perceived to have reduced doctors' workload and improved continuity of care for patients. However, three-quarters of pharmacists qualified to practise as supplementary prescribers were not actively prescribing, largely due to logistical and organisational barriers rather than inter-professional tensions. Independent prescribing was seen as contentious by mentors, particularly because of the diagnostic element.
Preparing hospital pharmacists to prescribe: stakeholders’ views of postgraduate courses
International Journal of Pharmacy Practice, 2012
Objectives To explore pharmacy stakeholders’ views on developing a postgraduate course to prepare hospital pharmacists for collaborative prescribing in Australia. Methods Semi-structured interviews were conducted with pharmacy stakeholders from universities, hospitals and professional organisations (n = 25) to gather views on the content, structure and delivery methods of a possible postgraduate prescribing course for pharmacists. Transcripts were analysed thematically and coded using NVivo software. Key findings There was strong support for collaborative prescribing as an appropriate role for advanced pharmacist practitioners and acknowledgement that further training is needed to implement this new role. It was proposed that postgraduate training for hospital pharmacists should be based on a national prescribing competency framework and participants highlighted key aspects of the prescribing process in which pharmacists need particular up-skilling: diagnosis, physical assessments, ...
An expanded prescribing role for pharmacists – an Australian perspective
Australasian Medical Journal, 2011
Expanded pharmacist prescribing is a new professional practice area for pharmacists. Currently, Australian pharmacists' prescribing role is limited to over-the-counter medications. This review aims to identify Australian studies involving the area of expanded pharmacist prescribing. Australian studies exploring the issues of pharmacist prescribing were identified and considered in the context of its implementation internationally. Australian studies have mainly focused on the attitudes of community and hospital pharmacists towards such an expansion. Studies evaluating the views of Australian consumers and pharmacy clients were also considered. The available Australian literature indicated support from pharmacists and pharmacy clients for an expanded pharmacist prescribing role, with preference for doctors retaining a primary role in diagnosis. Australian pharmacists and pharmacy client's views were also in agreement in terms of other key issues surrounding expanded pharmacist prescribing. These included the nature of an expanded prescribing model, the need for additional training for pharmacists and the potential for pharmacy clients gaining improved medication access, which could be achieved within an expanded role that pharmacists could provide. Current evidence from studies conducted in Australia provides valuable insight to relevant policymakers on the issue of pharmacist prescribing in order to move the agenda of pharmacist prescribing forwards. PEER REVIEW Not commissioned. Externally peer reviewed.
Identifying the perceived training needs for Australian pharmacist prescribers
2014
Objective To explore pharmacists' perceived needs on training required to undertake an expanded prescribing role taking account of their years of registration, current professional practice area and preferred prescribing model. Methods A piloted self-administered questionnaire was distributed nationally to a random sample of pharmacists. Data were analysed using SPSS version18 software where data cross-tabulations, chi-squared and one-way analyses of variance were performed. Key findings A response rate of 40.4% (1049/2592) was achieved. Pathophysiology of conditions, principles of diagnosis, and patient assessment and monitoring were the most preferred training topics. There was no difference (P = 0.620) in pharmacists' perceived needs for additional training with respect to the model of prescribing (i.e. supplementary or independent or both) and years of registration as pharmacists (P = 0.284). However, consultant pharmacists were less supportive of the need for additional training (P = 0.013). Pharmacists' years of registration and professional practice influenced their training topic preferences. Supporters of an independent prescribing model only demonstrated a weaker preference for training in key therapeutic topics (P = 0.001).
An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role
Pharmacy World & Science, 2010
Objectives To evaluate the views of Australian pharmacists on expanded pharmacist prescribing roles and identify important drivers and barriers to its implementation. Setting Pharmacists in Australia. Method Data were collected using a self-administered questionnaire distributed nationally to a random sample of pharmacists either directly, or in the case of one state, via community pharmacies. One-way ANOVA and , 2 testing were used to identify significant associations. Factor analysis was conducted to pool variables and the derived factors were subjected to regression analysis. Main outcome measures Perceptions of Australian pharmacists on expanded prescribing and the relationships between variables derived. Results A total of 2592 questionnaires were distributed and a response rate of 40.4% was achieved (n = 1049). Of the respondents 83.9% strongly agreed/agreed to an expanded prescribing role for pharmacists and 97.1% reported they would need further training. Of the respondents 896 agreed that pharmacists should engage in supplementary, independent prescribing or both. Of these 69.1% preferred only supplementary prescribing, 3.3% independent prescribing and 27.4% both models. Both models were found to be positive predictors of expanding pharmaceutical services through prescribing (P \ 0.001) with supplementary prescribing showing a stronger association (b = 0.52 vs. b = 0.18). Pharmacists' opinion based on their current perceptions of their clients was an important predictor in expanding pharmaceutical services through prescribing (P = 0.005). Inadequate training in patient assessment, diagnosis and monitoring were the strongest barriers to expanded pharmacist prescribing (P \ 0.001). Conclusions The majority of Australian pharmacists supported an expanded pharmacist prescribing role. Support for supplementary was stronger than independent prescribing. Pharmacists acknowledged that they would need further training to perform such roles.
Journal of pharmacy practice and research, 2018
Historically doctors prescribe and pharmacists dispense, but these clear lines are rapidly eroding. The view that pharmacists should work closely with general practitioners and hospital doctors is a reality. It is encouraged by surveys and major reports such as that of Lord Carter. This shift is mediated by the need to balance the authority of doctors and patient safety with a shortage of doctors and a need to use the skills of pharmacists appropriately. As the population ages, more pharmacists, with the necessary skills and knowledge, will be required.
England local community pharmacists opinions on independent prescribing training
Journal Of Advanced Pharmacy Education And Research, 2022
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