RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

93
Pharmacy prescribing in XXXX-a quantitative assessment
Laura McCann 1 , Carmel Hughes 1 , Fran Lloyd 2 , Sharon Haughey 1 , Carole Parsons 1 , Grainne
Crealey 3 , Gerry Gormley 4
1 School of Pharmacy, Queen's University, Belfast, United Kingdom, 2 Northern Ireland Centre for
Pharmacy Learning and Development, Queen's University, Belfast, United Kingdom, 3 Clinical
Research Support Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom,
4 Department of General Practice and Primary Care, School of Medicine, Dentistry and
Biomedical Sciences, Queen's University, Belfast, United Kingdom
Focal Points
• Using a postal survey this study sought to collect information on aspects of
structures and processes associated with pharmacist prescribing in XXXX.
• Most respondents reported that prescribing provided clinical benefits to patients
and professional benefits for them. There were some concerns with regard to
performing physical examinations
• There were perceived benefits for patients and pharmacists
Introduction Pharmacy prescribing is slowly becoming embedded in practice 1 . However, it is
recognised that despite enthusiastic uptake in opportunities to become a prescriber,
pharmacists have experienced problems in utilising their prescribing skills. As part of a
commissioned research project, this study (Phase 1 of a 3 phase study) sought data on aspects
of structures and processes associated with pharmacist prescribing in XXXX using a
questionnaire approach.
Method A structured self-administered questionnaire was sent to all prescribers (following an
initial telephone call to confirm prescribing status; n=100), on 2 occasions between September
and December 2009. Three versions were developed to accommodate the status of prescribing
pharmacists (current, previous, never). The questionnaire was piloted with a random sample of
prescribing pharmacists (n=30) in another jurisdiction and reviewed by 2 colleagues in the
researchers’ institution. Data were collected on aspects of prescribing such as: clinical area(s),
prescribing activities, barriers to prescribing and patient/pharmacist outcomes. Following
receipt of questionnaires, data were entered into SPSS (v.18) and analysed using descriptive
statistics and t-tests.
Results A 76.0% response rate (n=76) was achieved. There were more female respondents
(73.7%) than males (26.3%). Nearly 50% of respondent were currently prescribing (47.4%,
n=36), 46.1% (n=35) had never prescribed and 6.6% (n=5) had prescribed in the past. The
three most common clinical areas for current prescribers were hypertension, respiratory and
cardiovascular and diabetes management. Nearly 75% of current prescribers prescribed for <
50 patients/week (22.2%: 26-50 patients; 22.2%: 11-25 patients and 25.0%: 5-10 patients). A
number of barriers to implementing pharmacist prescribing were noted such as inadequate
funding, inadequate resources to cover other core services and onerous paperwork associated
with the Clinical Management Plan (CMP). Most pharmacists ‘agreed’ or ‘strongly agreed’ that
prescribing increased continuity of care [62/76 (81.58%)], increased patient
compliance/adherence [62/76 (81.6%)], improved patient safety [64/76 (84.3%)], elevated the
status of the prescribing pharmacist [66/76 (86.8%)], increased job satisfaction for the
prescribing pharmacist [69/76 (90.8%)] and increased professional autonomy [70/76 (92.1%)].
Most pharmacists ‘disagreed’ or ‘strongly disagreed’ with the statement that pharmacist
prescribing increased responsibility and accountability of pharmacists in a negative way [54/76
(71.1%)]. Over 30% of current prescribers felt that they were excellent at ‘opening the patient
consultation’ (30.6%) and answering patient questions (36.1%). However, only 5% of current
prescribers felt they were excellent at ‘undertaking physical examination of patients’ (5.6%)
while half (n=18) felt adequate in undertaking this activity (50%). Almost all current prescribers
[97.2% (35/36)] were significantly more likely to ''agree' or 'strongly agree' that prescribing
increases job satisfaction compared to 82.8% (29/35) of those who had never prescribed (P =
0.01); 88.9% (32/36) of current prescribers were significantly more likely to ''agree' or 'strongly