A cross sectional survey of the views of newly registered pharmacists in Great Britain on their potential prescribing role: a cautious approach

AIM

To investigate newly registered pharmacists'' awareness of pharmacist prescribing and views on potential future roles as prescribers.

METHODS

A mailed questionnaire was sent to all 1658 pharmacists joining the Pharmacist Register in 2009.

RESULTS

The response rate was 25.2% (n = 418). While most (86.4%) expressed interest in prescribing training, they acknowledged training needs in clinical examination, patient monitoring and medico-legal aspects of prescribing. Two thirds of respondents (66.3%) thought the current requirement of being registered as a pharmacist for 2 years prior to commencing prescribing training was appropriate.

CONCLUSION

Newly registered pharmacists are cautious in their approach to taking on prescribing training and roles.     

‘It's showed me the skills that he has’: pharmacists' and mentors' views on pharmacist supplementary prescribing

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. Conclusions Supplementary prescribing has been successful where it has been implemented but a number of barriers remain which are preventing the wider acceptance of this practice innovation.     

Exploring patients’ perspectives of pharmacist supplementary prescribing in Scotland

Aim The aim of this study was to explore patients’ perspectives and experiences of pharmacist supplementary prescribing (SP) in Scotland. Method A survey in primary and secondary care in Scotland. Pharmacist supplementary prescribers (n = 10) were purposively selected across Scotland. All pharmacists distributed questionnaires to 20 consecutive patients as they attended appointments during October to December 2006. Reminders were mailed to all 20 patients by each pharmacist 2 weeks after initial distribution. Main outcome measures The questionnaire contained items on: attitudes towards pharmacist SP derived from earlier qualitative research; consultation satisfaction derived from a validated scale developed initially for general practitioners, with the term ‘doctor’ being replaced by ‘pharmacist prescriber’; and demographics. Closed and Likert scales were used as response options. Results One pharmacist withdrew. The patient response rate was 57.2% (103/180). The median age was 67 years (interquartile range 56.5–73 years), with 53.4% being female. Most (76, 73.8%) consulted with the pharmacist in a general practice setting. Patients reported positive consultation experiences with 89.3% agreeing/strongly agreeing that they were satisfied with the consultation, 78.7% thought the pharmacist told them everything about their treatment and 72.9% felt the pharmacist was interested in them as a person. Most patients were positive in their attitudes, agreeing that they would recommend a pharmacist prescriber to others and that they had trust in the pharmacist. However, 65% would prefer to consult a doctor. Conclusion Most patient respondents were satisfied with, and had a positive attitude towards, pharmacist prescribing consultations. However, most patients would still elect to see a doctor given the choice.     

Exploring pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland

Objectives The introduction of non‐medical prescribing in the UK has provided opportunities and challenges for pharmacists to help ensure prudent use of antimicrobials. The objective of this research was to explore pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland. Methods Pharmacists' perceptions were explored using focus groups in five Scottish regions representing (a) urban and rural areas and (b) district general hospitals and large teaching centres. Senior hospital pharmacists, both prescribers and non‐prescribers, working in specialities where antimicrobials are crucial to patient management, were invited to participate. A topic guide was developed to lead the discussions, which were audio‐recorded and transcribed. The framework approach to data analysis was used. Key findings Six focus groups took place and some emerging themes and issues are presented. Pharmacists believed that the feasibility of antimicrobial prescribing is dependent upon the patient's clinical condition and the area of clinical care. They identified potential roles and opportunities for pharmacist prescribing of antimicrobials. Perceived benefits included giving patients quicker access to medicines, reducing risk of resistance and better application of evidence‐based medicine. Conclusions Pharmacists feel they have a good knowledge base to prescribe and manage antimicrobial treatment, identifying possible opportunities for intervention. Roles within a multidisciplinary antimicrobial team need to be clearly defined.     

Views of pharmacist prescribers,doctors and patients on pharmacist prescribing implementation

Aim The aim of this study was to explore the perspectives of pharmacist supplementary prescribers, their linked independent prescribers and patients, across a range of settings, in Scotland, towards pharmacist prescribing. Method Telephone interviews were conducted with nine pharmacist prescribers, eight linked independent prescribers (doctors) and 18 patients. The setting was primary and secondary care settings in six NHS Health Board areas in Scotland. Key findings In general, all stakeholders were supportive of pharmacists as supplementary prescribers, identifying benefits for patients and the wider health care team. Although patients raised no concerns, they had little idea of what to expect on their first visit, leading initially to feelings of apprehension. Pharmacists and doctors voiced concerns around a potential lack of continued funding, inadequate support networks and continuing professional development. Pharmacists were keen to undertake independent prescribing, although doctors were less supportive, citing issues around inadequate clinical examination skills. Conclusions Pharmacists, doctors and patients were all supportive of developments in pharmacist supplementary prescribing, although doctors raised concerns around independent prescribing by pharmacists. The ability of pharmacists to demonstrate competence, to be aware of levels of competence and to identify learning needs requires further exploration.     

Prevalence and satisfaction of discharged patients who recall interacting with a pharmacist during a hospital stay

Background:

To enhance the quality of patient care, the former Calgary Health Region (now part of Alberta Health Services) works continuously to improve pharmacy clinical services and to plan and implement new programs and services. Patient satisfaction is an important indicator of patients’ perception of the value of services provided.

Objectives:

To determine the baseline prevalence of patients admitted to the former Calgary Health Region with complex and high-risk medication needs who recalled speaking to a pharmacist during their hospital stay and their reported satisfaction with those interactions.

Methods:

A retrospective cross-sectional study was conducted by means of a telephone survey of patients shortly after discharge. Patients were asked whether they recalled speaking with a pharmacist during their last stay in the hospital. Patients who recalled such interactions were asked to rate pharmacy services on a 5-point scale.

Results:

Of 1200 patients who were discharged from hospital in June 2007 and who were contacted by telephone 2 months later, 400 patients agreed to participate in the survey; 3 of these patients were subsequently excluded. Of the 397 respondents included in the analysis, 83 (20.9%) recalled speaking to a pharmacist. Most of these rated the interaction favourably, with an average satisfaction rating of 4.4 out of 5.

Conclusions:

The Pharmacy Department of the former Calgary Health Region now has baseline frequency and satisfaction data for this indicator of service value, which can be used as comparators for future assessments of service value.     

药师处方权认知度和支持度的初步调查

目的：了解医护人员、药师和公众对药师"部分"处方权的认知度和支持度。方法：对医护人员、药师以及公众进行问卷调查。结果：医生、护士和公众对药师"部分"处方权非常清楚或比较清楚的分别占35.70%、36.24%、33.44%，药师占57.05%，医生、护士和公众对赋予药师"部分"处方权完全同意或同意的分别占82.01%、76.74%、83.12%，药师占94.82%，而且认知度与支持度在0.01水平上显著相关，不同年龄、学历、职业、职称、医院级别等的支持度有统计学意义。结论：医护人员、药师和公众对于药师"部分"处方权的概念、资格准入等内容认知不足，但认可赋予药师"部分"处方权的好处，并且对赋予药师"部分"处方权持积极态度，认知情况越好支持度越高；医护人员、药师和公众对于赋予药师"部分"处方权的支持度，存在"老年高于青年，高职称高于低职称，高级别医院高于低级别医院，学历差异较大"等现象。     

康健社区卫生服务中心临终关怀服务回顾

目的：回顾临终关怀服务实践,探讨社区临终关怀服务意义。方法：采用临终关怀门诊问卷,调查服务知晓度;对所有出院患者进行费用调查并与综合性医院比较;住院病例在入院时及两周后分别作《SCL-90症状自评量表》调查。结果：病人家属对临终关怀服务知晓度较高,主要通过媒体了解知晓本服务,患者最需要解决的问题是镇痛;与综合性医疗机构比较,社区开展临终关怀服务费用明显降低;治疗后抑郁和焦虑有轻度缓解。结论：社区卫生服务中心可成为临终关怀服务的主体。