Pharmacist supplementary prescribing: a step toward more independence?

Area of Science:

• Pharmacology and Pharmacy Practice
• Health Services Research

Background:

• Supplementary prescribing (SP) is a collaborative drug therapy management model in the UK since 2003.
• It involves an independent prescriber, a supplementary prescriber (e.g., nurse, pharmacist), and the patient, implementing a clinical management plan (CMP).

Purpose of the Study:

• To explore pharmacist prescribers' perspectives and experiences during the initial phase of SP implementation.
• Investigate the early adoption and integration of SP by pharmacists in clinical practice.

Main Methods:

• Qualitative, longitudinal study design utilizing semistructured interviews.
• Purposive sampling of 16 pharmacist supplementary prescribers in Southern England, with interviews at 3 and 6 months post-registration.
• Framework approach for data collection, management, and analysis.

Main Results:

• Three distinct pharmacist experience typologies emerged: 'a blind alley,' 'a stepping stone,' and 'a good fit.'
• SP was perceived as progress, improving patient care, healthcare team integration, and job satisfaction, despite implementation delays.
• Concerns included SP's bureaucracy and limitations on pharmacist decision-making, increasing support for the emerging pharmacist independent prescribing (IP) role.

Conclusions:

• The supplementary prescriber role marked a significant advancement for UK pharmacists, despite encountered challenges.
• Pharmacist SP may coexist with IP in specific clinical management plan contexts; otherwise, it may serve as a precursor to independent prescribing.
• Further objective research comparing SP and IP outcomes is crucial for informing pharmacist adoption of these prescribing roles.