Independent prescribing by hospital pharmacists: Patterns and practices in a Canadian province

Heck, Taryn; Gunther, Mary; Bresee, Lauren; Mysak, Tania; McMillan, Chloe L.; Koshman, Sheri L.

doi:10.2146/ajhp150080

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…Building harmonious relationships with health professionals is key to the implementation of PP . Supporting this, Canadian pharmacists were more likely to prescribe after interdisciplinary team discussions . This resonates with research studying the redistribution of occupational power and related improved coordination of healthcare teams, where a key component of collaboration is described as the ‘relative autonomy of clinicians over their scope of practice to deliver patient care’, requiring a shared understanding of roles .…”

Section: Discussionmentioning

confidence: 72%

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

Zhou

Desborough

Parkinson

et al. 2019

International Journal of Pharmacy Practice

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Objectives Non‐medical prescribers, including pharmacists, have been found to achieve comparable clinical outcomes with doctors for certain health conditions. Legislation supporting pharmacist prescribing (PP) has been implemented in the United Kingdom (UK), Canada and New Zealand (NZ); however, to date, Australian pharmacists have not been extended prescribing rights. The purpose of this review was to describe the barriers to PP found in the literature from the UK, Canada, NZ and Australia, and examine the implications of these for the development of PP in Australia. Methods We conducted a scoping review, which included peer‐reviewed and grey literature, and consultation with stakeholders. Sources – Scopus, PubMed and CINAHL; Google Scholar, OpenGrey and organisational websites from January 2003 to March 2018 in the UK, Canada, NZ and Australia. Inclusion criteria – articles published in English, related to implementation of PP and articulated barriers to PP. Key findings Of 863 unique records, 120 were reviewed and 64 articles were eligible for inclusion. Three key themes emerged: (1) Socio‐political context, (2) Resourcing issues and (3) Prescriber competence. The most common barriers were inadequate training regarding diagnostic knowledge and skills, inadequate support from authorities and stakeholders, and insufficient funding/reimbursement. Conclusions If implementation of PP is to occur, attention needs to be focused on addressing identified barriers to PP implementation, including fostering a favourable socio‐political context and prescriber competence. As such, a concerted effort is required to develop clear policy pathways, including targeted training courses, raising stakeholder recognition of PP and identifying specific funding, infrastructure and resourcing needs to ensure the smooth integration of pharmacist prescribers within interprofessional clinical teams.

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Section: Discussionmentioning

confidence: 72%

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

Zhou

Desborough

Parkinson

et al. 2019

International Journal of Pharmacy Practice

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“…This finding contrasts with the previous survey of hospital pharmacists in Alberta where APA was used most frequently to adjust medication dosages and for medication reconciliation. 21 However, neither this study nor the previous asked pharmacists to describe the degree of involvement they have in each clinical activity. Although 100% of oncology pharmacists with APA are involved with medication reconciliation, the degree of involvement they have and their established role among the multidisciplinary team in their practice may influence how useful prescribing is for this particular activity.…”

Section: Discussionmentioning

confidence: 88%

“…In 2014, a web-based survey was done to determine the prescribing frequency of hospital pharmacists in Alberta with APA. 21 Although it was not restricted to oncology pharmacists, it captured information applicable to pharmacists with APA in Alberta. They found that the majority of hospital pharmacists practiced in acute care and inpatient settings.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there are limitations to using previous surveys conducted in Alberta to make direct comparisons. Heck et al 21 conducted the survey two years ago and it did not focus on oncology pharmacists. Furthermore, the utilization of APA in practice may have changed over the last two years and there may be a different interpretation of medication reconciliation between the two groups of people.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of additional prescribing authorization among oncology pharmacists in Alberta

Dersch‐Mills

Ghosh

et al. 2018

J Oncol Pharm Pract

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Purpose To describe the practice settings and prescribing practices of oncology pharmacists with additional prescribing authorization. Methods A descriptive, cross-sectional survey of all oncology pharmacists in Alberta was conducted using a web-based questionnaire over four weeks between March and April 2016. Pharmacists were identified from the Cancer Services Pharmacy Directory and leadership staff in Alberta Health Services. Descriptive statistics were used to describe the practice setting, prescribing practices, motivators to apply for additional prescribing authorization, and the facilitators and barriers of prescribing. Logistic regression was used to explore factors associated with having additional prescribing authorization. Results The overall response rate was 41% (71 of 175 pharmacists). Oncology pharmacists with additional prescribing authorization made up 38% of respondents. They primarily worked in urban, tertiary cancer centers, and practiced in ambulatory care. The top 3 clinical activities they participated in were medication reconciliation, medication counseling/education, and ambulatory patient assessment. Respondents thought additional prescribing authorization was most useful for ambulatory patient assessment and follow-up. Antiemetics were prescribed the most often. The median number of prescriptions written in an average week of clinical work was 5. Competence, self-confidence, and the potential impact on patient care/perceived impact on work environment were the strongest facilitators of prescribing. The strongest motivators to apply for additional prescribing authorization were relevancy to practice, the potential for increased efficiency, and advancing the profession. Conclusion The current majority of oncology pharmacist prescribing in Alberta occurs in ambulatory care with a large focus on antiemetic prescribing. Pharmacists found additional prescribing authorization most useful for ambulatory patient assessment and follow-up.

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“…Alberta was the first province in Canada to approve independent prescribing for pharmacists. 59 We are seeing extended services such as drug ordering and monitoring by clinical pharmacist practitioners in ICUs in the United States. 14 The role of the pharmacist as an independent prescriber is becoming a reality and will likely continue to grow, which may result in improved prescribing with better accuracy.…”

Section: Pharmacist Prescribingmentioning

confidence: 99%

Outcome Assessment of Critical Care Pharmacist Services

Bauer

Kane‐Gill

2016

Hosp Pharm

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Independent prescribing by hospital pharmacists: Patterns and practices in a Canadian province

Cited by 15 publications

References 16 publications

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

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

Implementation of additional prescribing authorization among oncology pharmacists in Alberta

Outcome Assessment of Critical Care Pharmacist Services

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