Medicines prescribed by non-medical independent prescribers in primary care in Wales: a 10-year longitudinal study April 2011–March 2021

Abstract

ObjectivesThe therapeutic classes of medicines prescribed by non-medical independent prescribers (NMIPs) working in primary care in Wales has not been studied in detail. The aim of this study was to conduct a 10-year longitudinal analysis of NMIP prescribing in Wales from April 2011 to March 2021. The study examined the British National Formulary (BNF) chapters from which medicines were prescribed by NMIPs, whether this changed over time, and whether there was variation in prescribing across the geographic regions of Wales.DesignRetrospective secondary data analysis of primary care prescribing data. Monthly prescribing data for the 10 National Health Service financial years (April to March) from April 2011 to March 2021 were obtained from the Comparative Analysis System for Prescribing Audit software. Data were analysed according to BNF chapter, to identify in which therapeutic areas NMIPs were prescribing, and whether this changed over the study period.ResultsThe number of items prescribed by NMIPs increased during the study period. From April 2011 to March 2021 prescribing in seven BNF chapters equated to approximately 80% of total items, with cardiovascular system medicines most prescribed. In the financial year 2011–2012 the BNF chapters with the greatest proportion of items prescribed were infection (18%) and respiratory system (13%), while in 2020–2021, these had changed to cardiovascular (23%) and nervous system (19%). The number of items prescribed in each health board in Wales varied, however, the BNF chapters contributing the largest percentages of items to the health board totals were broadly comparable.ConclusionsThe BNF chapter with the most prescribed items changed from infection to cardiovascular during the study period, suggesting an increase in chronic disease management by NMIPs. The impact of this on the delivery of primary care services and patient outcomes is a focus for future work.

Assessment of the Prescribing Pharmacist’s Role in Supporting Access to Prescription-Only Medicines—Metadata Analysis in Poland

“…Similarly, a study in Wales conducted over a 10-year period (April 2011 to March 2021) analyzed prescribing by non-medical independent prescribers. They found that substances from seven groups of the BNF classification-cardiovascular, the nervous system, infections, the respiratory system, the endocrine system, the gastrointestinal system, and skin-accounted for about 80% of all prescriptions, with cardiovascular drugs being the dominant group [28,29]. These were also the groups of substances most frequently prescribed by pharmacists in our study.…”

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“…Compared to other published research from the United Kingdom and parts of Europe, these medications differ from what was most commonly reported as prescribed by pharmacists, which included cardiovascular, nervous system, respiratory system, and infectious diseases medications. 33 , 34 Given differences across countries in when independent prescribing for pharmacists began, and related differences in approved conditions for prescribing, this is not unexpected. Many research studies have demonstrated the efficacy and safety of pharmacist prescribing 35 , 36 for conditions such as uncomplicated cystitis, with demonstrated patient satisfaction with this practice.…”

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