Pharmacist Prescribing: Review of the Literature

Kay, Olivia; Brien, Jo‐anne E

doi:10.1002/jppr2004344300

Cited by 23 publications

(28 citation statements)

References 41 publications

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“…Early experience from supplementary prescribers in the UK has suggested inadequate funding to be a major limitation for delivering this service [18]. Review of the literature revealed a variety of other limitations including potential conflict with doctors, need for greater liability insurance, excessive workload and time pressures [19][20][21][22]. A possibility for fragmentation of care resulting in increased costs and inefficiencies within the health care system has also been reported [9].…”

Section: Discussionmentioning

confidence: 99%

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An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

et al. 2010

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Section: Discussionmentioning

confidence: 99%

“…They are also valuable elsewhere, given the global interest on this issue and the lack of literature exploring pharmacists' views outside of the UK [17,19,29].…”

Section: Discussionmentioning

confidence: 99%

An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

et al. 2010

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“…25 In the US and Canada, pharmacists are able to legally prescribe a range of medicines. 29,30 In the USA, protocol-based prescribing by pharmacists by 2001 had been successfully legislated in at least 25 states. 29 The limited international experiences to date (UK, US, and Canada) suggest that pharmacists are capable of prescribing a range of drug therapies safely and effectively, including oral contraceptives, analgesics, antihypertensives and warfarin.…”

Section: Pharmacist Prescribingmentioning

confidence: 99%

“…29 The limited international experiences to date (UK, US, and Canada) suggest that pharmacists are capable of prescribing a range of drug therapies safely and effectively, including oral contraceptives, analgesics, antihypertensives and warfarin. [29][30][31][32][33][34][35] Expanded roles for pharmacists The pharmacy profession is currently exploring expanded roles in primary care. These include prevention and aspects of chronic disease management 36 with medication reviews in individuals' homes or residential aged care facilities, 37,38 and the development of formularies and reviewing repeat prescriptions.…”

Section: Pharmacist Prescribingmentioning

confidence: 99%

Doctor and pharmacist — back to the apothecary!

Liaw¹,

Peterson²

2009

Aust. Health Review

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The Australian National Medicines Policy embodies four tenets: availability, quality, safety and efficacy of medicines; timely access to affordable medicines; quality use of medicines (QUM); and a responsible and viable medicines industry. The promotion of QUM requires a multidisciplinary approach, including contributions from government, the pharmaceutical industry, health professionals, consumers and academia. However, there are significant tensions and unintended effects associated with the multidisciplinary approach, especially with the relationships between prescribers and dispensers of medicines.The general practitioner and the pharmacist share a common ancestor -the apothecary. The separation of dispensing from prescribing, which began in medieval Europe and 19th century England, reframed and confined the patient-doctor relationship to one of diagnosis, prescription and non-drug management. The role of pharmacists was limited to dispensing, though the present trend is for their responsibilities to be widened. Historical antecedents, the contribution of an increasing number of actors to the costs of health care, universal health insurance and an evolving regulatory framework, are among the factors influencing doctor-pharmacist relations.The prescribing and dispensing of medicines must be guided by an ethical clinical governance structure encompassing health professionals, regulators, the pharmaceutical industry and consumers. There must be close monitoring of safety and effectiveness, and promotion of quality use of medicines and improved patient outcomes. Ongoing training and professional development, within and across professional boundaries, is essential to support harmonious and cost-effective interprofessional practice. The approach must be "apothecarial" with complementary roles and responsibilities for the prescriber and dispenser within the patient-clinician therapeutic relation- ship, and not adversarial.

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“…[160] In a literature review in 2004, Kay et al identified only 18 studies conducted since the 1970's which measured outcomes comparing pharmacist prescribing to standard care. [161] The summary reported positive outcomes associated with pharmacist prescribing included: improvement in disease control; improvement in compliance; improved patient outcomes; reduced adverse effects; fewer drugs prescribed; reduced death rate; increased discharge rate; and, reduced resource utilisation.…”

Section: Pharmacistsmentioning

confidence: 99%

Doctor - pharmacist collaborative prescribing in a multidisciplinary surgical preadmission clinic: Expanding the role of the preadmission clinic pharmacist

Hale¹

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Non-medical prescribing has been introduced in to several countries, with prescribing privileges being granted to health practitioners other than doctors, including pharmacists. The objectives behind the introduction of this new model of health care have been to create a more flexible system for the prescribing, dispensing and administration of medicines, increase access for the general public to safe and appropriate prescription medications, and to better utilise the skills of the current health workforce.Current research on non-medical prescribing is predominantly qualitative, with little evidence as to the safety, appropriateness, effectiveness or cost effectiveness of the prescribing. Pharmacist prescribing is yet to be introduced in Australia, and in light of some resistance it is important to ensure that this potential model of care meets expectation, prior to implementation.The overall aim of this thesis is to evaluate a model of pharmacist prescribing in an elective surgery pre admission clinic (PAC), using the validated National Health Performance Framework (NHPF), which was revised and approved by Australian Ministers in 2009. The framework uses six dimensions to assess how a health system performs; 'effectiveness', 'safety', 'responsiveness', 'continuity of care', 'accessibility' and 'efficiency and sustainability'.A randomised controlled trial was undertaken in PAC, with 400 patients randomised in to either the intervention or control arm. Patients in the intervention arm were seen by a nurse, Resident Medical Officer (RMO), anaesthetist and the pharmacist prescriber. The pharmacist was responsible for the taking of a medication history, and prescribing the national inpatient medication chart (NIMC) to reflect the patient's regular medications and the plan for medications peri operatively. Within the pharmacist's agreed scope of practice was also the initiation of venous thromboembolism (VTE) prophylaxis, following a risk and contraindication assessment. Patients randomised in to the control arm still saw the same four healthcare professionals, including a pharmacist for usual care duties.The prescribing of the medication chart, including VTE prophylaxis, was the responsibility of the Resident Medical Officer (RMO) from the treating surgical team. The primary end point of the study was the safety and accuracy of the NIMC. The secondary end point was the appropriateness of VTE prophylaxis prescribed in clinic.Medications charts were audited against the medication history and plan for medication peri operatively. Medication charts in the intervention arm contained significantly fewer omissions of regular medications, significantly less prescribing errors involving selection of drug, dose or frequency and significantly fewer orders with at least one component of the prescription missing, incorrect or unclear. VTE risk assessments were documented, and prophylaxis was prescribed, significantly more appropriately in clinic.iii The significant differences between arms in omissions of medication p...

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Pharmacist Prescribing: Review of the Literature

Abstract: Aim: To evaluate the literature describing pharmacist prescribing activities and identify areas in need of further research.

Cited by 23 publications

References 41 publications

An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

Doctor and pharmacist — back to the apothecary!

Doctor - pharmacist collaborative prescribing in a multidisciplinary surgical preadmission clinic: Expanding the role of the preadmission clinic pharmacist

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Pharmacist Prescribing: Review of the Literature

Abstract: Aim: To evaluate the literature describing pharmacist prescribing activities and identify areas in need of further research.

Cited by 23 publications

References 41 publications

An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

An evaluation of Australian pharmacist’s attitudes on expanding their prescribing role

Doctor and pharmacist &mdash; back to the apothecary!

Doctor - pharmacist collaborative prescribing in a multidisciplinary surgical preadmission clinic: Expanding the role of the preadmission clinic pharmacist

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Doctor and pharmacist — back to the apothecary!