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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
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Pharmacist Prescribing at Inpatient Discharge in Alberta.

Reem Almawed1, Jennifer Shiu2, Tammy Bungard3

  • 1, PharmD, ACPR, is with Pharmacy Services, Alberta Health Services, Edmonton, Alberta.

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Inpatient pharmacists with additional prescribing authorization (APA) in Alberta prescribed for only a minority of patients at discharge. Barriers like fear of liability and discomfort with responsibility limited their prescribing practices.

Keywords:
additional prescribing authorizationdischargeinpatient pharmacyprescribing

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Area of Science:

  • Pharmacy Practice
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Pharmacists in Alberta can obtain additional prescribing authorization (APA) to independently prescribe medications.
  • No prior literature has examined pharmacist prescribing for inpatients at the time of hospital discharge.

Purpose of the Study:

  • To determine the proportion of patients for whom inpatient pharmacists with APA prescribed at discharge in Alberta.
  • To describe discharge interventions, enablers, barriers, and variations in discharge prescribing practices.

Main Methods:

  • A descriptive, cross-sectional web-based survey was administered to inpatient pharmacists with APA in Alberta.
  • Data were collected over a 6-week period in early 2022 from 104 respondents.

Main Results:

  • Less than half (44.1%) of surveyed pharmacists reported prescribing at discharge, and they did so for a median of 14.5% of their patients.
  • Supportive care teams were the most common enabler, while the presence of other prescribers was the most frequent barrier.
  • Pharmacists not prescribing at discharge cited discomfort with responsibility and fear of professional liability more often than those who did prescribe.

Conclusions:

  • Inpatient pharmacist discharge prescribing is utilized for a minority of patients and practices vary significantly across Alberta.
  • Further research is needed to identify strategies for overcoming barriers to pharmacist discharge prescribing.