Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey

Noblet, Tim; Marriott, John; Jones, Taryn; Dean, Catherine M.; Rushton, Alison

doi:10.1136/bmjopen-2018-026327

Cited by 3 publications

(6 citation statements)

References 23 publications

(29 reference statements)

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“…Improvements in the efficiency of healthcare delivery, access to medicines and reductions in costs across the health economy were suggested as potential benefits. These findings concur with those reported by student physiotherapists in Australia as detailed in a related article,16 as well as reflecting an evaluation of physiotherapist and podiatrist independent prescribers in the UK,27 strengthening the external validity and transferability of the results. Concerns regarding clinical safety and management of clinical risk were clearly identified throughout the quantitative and qualitative sections of the survey, supporting the results of an international multiprofession mixed-methods systematic review investigating the barriers and facilitators of the implementation and utilisation of NMP 5.…”

Section: Discussionsupporting

confidence: 88%

“…This article reports the data collected from registered physiotherapists from a larger study evaluating both registered and student physiotherapists in Australia 13. The data collected evaluating the views and perceptions of student physiotherapists about the implementation of physiotherapist prescribing in Australia are presented in the related article published independently 16…”

Section: Methodsmentioning

confidence: 99%

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Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists

et al. 2019

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ObjectivesTo explore: (1) the views of Australian physiotherapists regarding potential implementation of non-medical prescribing in Australia, (2) how the geographical location and health sector in which a clinician works may influence their perceptions and (3) the perceptions of Australian physiotherapists about how physiotherapist prescribing might impact the care that the profession can provide.DesignA cross-sectional descriptive survey using open and closed questions.SettingParticipants completed an online questionnaire.Participants883 Australian Health Professionals Registration Authority (AHPRA)-registered physiotherapists, working across all states and territories.Outcome measuresAn online questionnaire was developed by a panel of subject experts and pretested (n=10) for internal consistency. A hyperlink to the questionnaire was emailed to all members of the Australian Physiotherapy Association. A reminder email was sent 4 weeks later. Quantitative data were analysed descriptively, with use of absolute risk reductions (ARRs) and 95% CIs to determine the likelihood that health sector or geographical location were associated with specific views. Thematic analysis enabled synthesis of the qualitative data.Results79.0% participants felt that physiotherapist prescribing should be introduced in Australia, with 71.2% wanting to train as prescribers. Clinical governance, risk management, regulation of clinicians and the development of an education framework were identified as priorities for implementation. Participants working in the private sector were significantly more likely to train as prescribers than those in the public sector (ARR 9.9%; 95% CI 3.5 to 16.4) or educational/research institutions (ARR 23.3%; 95% CI 12.8 to 33.8), with city dwellers significantly more likely to train compared with physiotherapists in remote regions (ARR 19.8%; 95% CI 0.8 to 39.2). Physiotherapist prescribing was predicted to improve efficiency of healthcare delivery, access to medicines and reductions in healthcare costs.ConclusionsAHPRA-registered physiotherapists perceive that the introduction of autonomous physiotherapist prescribing would be beneficial for the Australian population and should be introduced. Decision makers should consider the results of this survey in conjunction with cost–benefit and risk analysis when planning the introduction of physiotherapist prescribing.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists

et al. 2019

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“…The major concern noted was the lack of pharmacological knowledge required to prescribe appropriately. Australian student physiotherapists have also emphasised the need for educational prerequisites that support prescribing competencies (Noblet et al 2018 ). A study that investigated the competency of non-medical prescribers in pharmacovigilance proved that most non-medical prescribers did not feel competent enough regarding adverse drug reaction reporting (Stewart et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…As a result, medical practitioners and nurses are the only prescribing authorities generally available in primary healthcare (Daviaud & Chopra 2008 ). A heavily discussed way to overcome pharmacotherapeutic healthcare challenges is to broaden the scope of practice of other healthcare providers to include non-medical prescription (Noblet et al 2018 ; Eales 2003 ); however, it should be acknowledged that healthcare provision is a multifactorial issue. Such issues include poor infrastructure (Maphumulo & Bhengu 2019 ), inequality between the public and private healthcare sector (Ataguba, Day & McIntyre 2015 ; ASSAf Standing Committee on Health 2020 ), inaccessibility of healthcare in many rural settings (Gaede & Versteeg 2011 ; Neely & Ponshunmugam 2019 ) and low funding expenditure for healthcare (Doherty et al 2002 ; Hlafa, Sibanda & Hompashe 2019 ).…”

Section: Introductionmentioning

confidence: 99%

South African physiotherapists’ attitudes to medicine prescription as an extension of practice

Kakono,

Mathye,

Brand

et al. 2023

South African Journal of Physiotherapy

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Background: The extension of medicine prescription rights to other healthcare providers was proposed to reduce pharmacotherapeutic service delivery challenges in the South African healthcare sector. The scope of practice of physiotherapists is being reviewed to possibly include prescription rights to promote service delivery.Objectives: Our study assessed the attitudes of registered South African physiotherapists to the inclusion of prescription rights in their scope of practice, including enablers and challenges, and the drug classes they believe to be most relevant.Method: A cross-sectional descriptive survey of South African registered physiotherapists was completed using an online questionnaire.Results: A total of 359 participants completed the questionnaire, where 88.2% agreed that prescribing rights should be introduced, and 87.64% would want to be trained to prescribe. Participants identified several benefits: improved service delivery (91.3%); reduced healthcare delivery costs (89.8%); decreased need for multiple healthcare practitioner consultations (93.2%). Concerns included: inadequate training (55%); increased workload (18.7%); increased insurance premiums against medical liability claims (46.2%). Drugs of relevance included analgesics (95.6%) and bronchodilators (96.0%), while low preference was placed on drugs unrelated to physiotherapy. Chi-square analysis revealed associations between specific drug classes and fields of expertise.Conclusion: South African physiotherapists agree that prescribing and a limited formulary would benefit their scope of practice; however, educational concerns are evident.Clinical implications: Findings support the drive to extend the South African physiotherapy scope of practice, however, investigation will be needed to determine the most appropriate way to capacitate future physiotherapists and current graduates should the extension be approved.

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“…Whilst the UK has achieved independent prescribing rights for physiotherapists, Australia is still lobbying for those rights. Noblet et al (2018), Noblet et al (2019a) and Noblet et al (2019b) undertook a multi-faceted study to gather prospective views of physiotherapists and physiotherapy students in relation to the potential implementation of physiotherapist prescribing in Australia. Anticipated benefits mainly focussed on improved delivery of health services (80.1%).…”

Section: Introductionmentioning

confidence: 99%

The experiences of physiotherapy independent prescribing in primary care: implications for practice

Mullan

Smithson

Walsh

2023

Prim Health Care Res Dev

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Aim: To explore the experiences of musculoskeletal (MSk) physiotherapy independent prescribing in primary care from the perspectives of physiotherapists and General Practitioners (GPs) and identify the implications these have for contemporary physiotherapy practice in primary care. Background: Legislative change in the United Kingdom (UK) in 2013 enabled physiotherapists holding a postgraduate non-medicalprescribing qualification to independently prescribe certain drugs that assist in patient management. Independent prescribing by physiotherapists is a relatively contemporary development in role change and purpose, occurring alongside the development of physiotherapy first contact practitioner (FCP) roles in primary care. Methods: A critical realist approach was used, with qualitative data collected via 15 semi-structured interviews with physiotherapists and GPs in primary care. Thematic analysis was applied. Participants: Fifteen participants were interviewed (13 physiotherapists, 2 GPs). Of the 13 physiotherapists, 8 were physiotherapy independent prescribers, 3 were MSk service leads, and 3 were physiotherapy consultants. Participants worked across 15 sites and 12 organisations. Findings: Whilst physiotherapists were empowered by their independent prescribing qualification, they were frustrated by current UK Controlled Drugs legislation. Physiotherapists reported vulnerability, isolation, and risk as potential challenges to independent prescribing, but noted clinical experience and ‘patient mileage’ as vital to mitigate these. Participants identified the need to establish prescribing impact, particularly around difficult to measure aspects such as more holistic conversations and enhanced practice directly attributed to prescribing knowledge. GPs were supportive of physiotherapists prescribing. Conclusions: Establishment of physiotherapy independent prescribing value and impact is required to evaluate the role of, and requirement for, physiotherapy independent prescribers within primary care physiotherapy FCP roles. Additionally, there is a need for a review of physiotherapy prescribing permitted formulary, and development of support mechanisms for physiotherapists at individual and system levels to build prescribing self-efficacy and autonomy, and to advance and sustain physiotherapy independent prescribing in primary care.

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Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey

Cited by 3 publications

References 23 publications

Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists

Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists

South African physiotherapists’ attitudes to medicine prescription as an extension of practice

The experiences of physiotherapy independent prescribing in primary care: implications for practice

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