A qualitative study of UK pharmacy pre-registration graduates' views and reflections on pharmacist prescribing

Abstract

Background Pre‐registration pharmacy graduates are a key group in relation to developing and implementing innovations in practice. Objective To explore the views and reflections on pharmacist prescribing of UK pre‐registration pharmacy graduates. Method Semi‐structured telephone interviews with a sample (n = 12) of pre‐registration pharmacy graduates. Key findings Most reported a desire to train as prescribers, largely for reasons of professional development, but acknowledged the need first to develop as pharmacists. They perceived the lack of organisational strategy, pharmacist prescribers' self‐confidence and additional workload to be barriers and were aware of the value of interprofessional relationships as potential facilitators to pharmacist prescribing. Conclusion While participants were supportive of pharmacist prescribing, they highlighted the need first to gain experience as pharmacists and were acutely aware of barriers to prescribing implementation.

Stakeholders' views and experiences of pharmacist prescribing: a systematic review

“…Many studies ( n = 27, 42%) reported facilitators and barriers to the implementation of pharmacist prescribers as perceived by the different stakeholder groups , which are summarized in Table .…”

“…The main barriers reported are pharmacists' poor clinical skills if not prescribing collaboratively and issues relating to resources (access to medical records, shortage in pharmacy workforce, funding, time), support (doctors’ opposition), logistics (accountability, conflict of interest, referral process) and poor recognition of pharmacy profession .…”

Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences

“…Inadequate support from authorities, employers, pharmacists, other health professionals and the public : Of 23 studies reporting this, most were from the UK, followed by Canada, NZ and Australia . From the number of articles mentioned this theme, other health professionals, including pharmacists, were nominated as providing the least support, followed by authorities, employers, and patients or the public . Insufficient support from organisation and management teams was reported in the UK, including allocated time for required training or prescribing practice, or support staff to check prescriptions.…”

“…Lack of relevant governance procedures to support PP : Governance refers to mechanisms that support organisational operation, including administration, risk management and ethical issues . The need for relevant governance was reported as essential to enable PP in 13 studies (from the UK, Canada and Australia). Lack of governance resulted in an absence of clearly defined roles and allocated time for PP, and a lengthy application process, leading to a reluctance to apply for additional prescribing rights among Canadian pharmacists .…”

“…Difficulties in making decisions about prescribing : This barrier was reported in 10 studies (from the UK and Canada). Specific factors included low self‐confidence, perceptions of risk due to the error‐prone nature of prescribing, limited flexibility due to clinical management plan adherence, little contact with patients to gain a full clinical picture, little experience with prescribing, inadequate communication and involvement with stakeholders and inadequate communication skills . Decision‐making in PP is, by its nature, complex and affected by many factors, including self‐confidence, work experience, communication skills and interactions with other stakeholders …”