Antibiotics are frequently supplied without prescription in many countries. This overuse of antibiotics could facilitate the development and spread of antibiotic resistance.

Background: In Nigeria, only medical doctors, dentists and some nurses in primary care

Objectives: This study was carried out to: 1) explore the views of pharmacists in Nigeria on the extension of prescribing authority to them and determine their willingness to be prescribers 2) identify the potential facilitators and barriers to introducing pharmacist prescribing in Nigeria.Method: An online cross-sectional survey was conducted from August to October 2014 among 775 pharmacists recruited from the Facebook group of the Pharmaceutical Society of Nigeria using a simple random technique. The questionnaire used for the survey was developed based on the review of the literature and previous qualitative studies conducted in Nigeria. The instrument was evaluated for content validity by two external pharmacy practice researchers and the reliability of items assessed using internal consistency tests. Data obtained from the survey were entered into SPSS v.22 and descriptive statistics were generated. Relationships between variables were evaluated using the chi-square test and p < 0.05 was considered statistically significant. Key findings:The response rate was 40.6% (315/775). Three hundred and six (97.1%) respondents agreed that pharmacists should be given prescribing authority. Of these 306, 295 (96.4%) were willing to be prescribers and just over half of them (148/295; 50.2%) would prefer to prescribe in collaboration with medical doctors. Of those willing to be prescribers, 285 (96.6%) reported that they would need additional training. The most perceived areas of training needed were in the principles of differential diagnosis (81.4%), pathophysiology of diseases (74.0%) and interpretation of laboratory results (68.1%). Respondents identified increasing patients' access to care (308/315; 97.8%) and better utilisation of pharmacists' skills (307/315; 97.5%) as the most likely facilitators to pharmacist prescribing in Nigeria. On the other hand, resistance from the medical doctors (299/315; 94.9%) and pharmacists' inadequate skills in diagnosis (255/315; 81.0%) were perceived as the most likely barriers. Conclusion:Pharmacist prescribing represents an opportunity to promote patients' access to care and the utilisation of pharmacists' skills in Nigeria. The majority of pharmacists showed a positive attitude towards pharmacist prescribing and were willing to be prescribers. The findings of this study could potentially contribute to future medicine prescribing policy and pharmacy practice in Nigeria.

Rationale, aims and objectives: In Nigeria, a shift from the traditional pharmacists' role of dispensing and compounding of medications began in the 1980s with the introduction of drug information services and unit dose dispensing systems in some hospitals. More than three decades after this, clinical pharmacy practice is still underdeveloped. This study was conducted to explore stakeholders' views on the barriers to the development of clinical pharmacy practice in Nigerian hospitals.Methods: Qualitative, semi-structured interviews were conducted with 44 purposefully sampled Nigerian stakeholders including pharmacists, pharmacy technicians, doctors, policymakers and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed thematically.Results: Three major themes emerged from the study: pharmacists' professional identity, the structure of pharmacy practice and external barriers. The results revealed an ongoing struggle by Nigerian hospital pharmacists to establish their clinical identities as many non-pharmacy stakeholders viewed pharmacists' roles to be mainly supply-based. Barriers to the development of clinical pharmacy practice identified included pharmacists' lack of confidence, shortage of pharmacy staff, underutilisation of pharmacy technicians, lack of specialisation and clinical career structure, medical dominance and opposition, and lack of policies that support clinical pharmacy practice. Conclusion:Several years after its introduction, clinical pharmacy practice is yet to be fully developed in Nigerian hospitals. The barriers identified in this study need to be addressed in order for clinical pharmacy practice to flourish.