Increased Accessibility to Primary Healthcare Due to Nurse Prescribing of Medicines

Abstract

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this study was to assess the impact of structural changes which increased the nurses’ competences on the accessibility to prescription visits for patients receiving primary healthcare on the example of Medical and Diagnostic Centre (MDC), and to discuss the general trend of legal changes in nursing profession regulations. We performed a detailed analysis of the data on the MDC patient population in Siedlce who received at least one prescription written by a general practitioner and/or a nurse/midwife in the years 2017–2019.The largest number of prescription visits made by nurses concerned patients aged 50–70 years, as this age range includes the largest number of patients with chronic diseases who need continued pharmacological treatment originally administered by doctors. An increasing tendency for prescription visits made by nurses was recorded, with a simultaneous downward trend in the same type of visits undertaken by doctors at MDC. Nurses’ involvement in prescribing medications as a continued pharmacotherapy during holiday seasons results in patients having continuous access to medication. An upward trend was also observed in the number of medications prescribed by nurses per patient. Structural changes in the legal regulations of the nursing profession improve patients’ access to prescription visits under primary healthcare. Further research is recommended to evaluate the dynamics of these trends and the impact of newly introduced nursing competences on the accessibility of prescription visits for patients.

Implementation of Nurse Prescriptions throughout the Public Health System in Catalonia (2021–2022)

“…The number of nurses who issued prescriptions in Catalonia increased from 3604 in 2021 to 5563 in 2022. Similar increases were reported in Poland, where the number of nurse prescriptions increased nearly sixfold, and the number of nurse prescribers doubled [ 34 ]. A retrospective study in Wales also found that the number of prescribing nurses doubled, and the prescriptions increased greatly after implementation in primary care [ 35 ].…”

“…During the second year, although 85% of the nurse prescriptions issued corresponded to these products, more nurse prescriptions for medication were issued than in the previous year, possibly owing to nurses’ expertise and their demand to expand the catalogue of medications that nurses can prescribe. Other authors have reported a significant increase in nurse prescriptions for medications in patients with chronic disease [ 34 ]. Other studies have also found a preponderance of prescriptions for health products [ 36 ].…”

Práticas Coletivas E Individuais Associadas À Dificuldade Dos Enfermeiros Da Atenção Primária À Saúde

“…(25) No Brasil, não é exigido ao enfermeiro da APS nenhuma especialização ou mestrado para realizar a prescrição como ocorre em outros países. (4,(22)(23)(24)26,27) No cuidado a pessoa com hipertensão e diabetes é competência do médico estabelecer o diagnóstico e prescrição inicial, sendo atribuição do enfermeiro o monitoramento e a manutenção da prescrição médica. Também competência para instituir o tratamento no caso de ausência do médico e agendar posteriormente a consulta médica, como no caso do protocolo da tuberculose.…”

“…As mudanças estruturais que aumentaram as competências dos enfermeiros levaram a um aumento das consultas com prescrição de medicamentos feitas por enfermeiros entre 2017 a 2019. (27) As práticas de enfermagem individuais e coletivas, exercidas com autonomia dentro dos regulamentos Enferm Foco. 2024;15(Supl 1):e-202404SUPL1 5 locais, promovem melhoria no acesso aos cuidados na APS em áreas de escassez de profissionais de saúde.…”