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Enabling pharmacist prescribing: Lessons learned in Nova Scotia using behaviour change theory.

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Pharmacist prescribing in Nova Scotia surged during COVID-19. Key facilitators included knowledge and supportive environments, while barriers involved environmental context and fear of negative outcomes, highlighting needs for optimized practice.

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Area of Science:

  • Pharmacy Practice
  • Health Services Research

Background:

  • The COVID-19 pandemic accelerated the demand for pharmacist prescribing in Nova Scotia due to increased patient needs, expanded scope of practice, and government funding.
  • This created an urgent need to understand the factors influencing this practice shift.

Purpose of the Study:

  • To investigate the barriers and facilitators impacting pharmacist prescribing in Nova Scotia.
  • To inform strategies for optimizing and fully implementing pharmacist prescribing.

Main Methods:

  • A sequential explanatory mixed-methods study was conducted.
  • Utilized a cross-sectional survey and semi-structured qualitative interviews with community pharmacists.
  • Employed the Behaviour Change Wheel, including the Capability Opportunity Motivation Model of Behaviour Change (COM-B) and Theoretical Domains Framework version 2 (TDFv2).

Main Results:

  • Pharmacist prescribing frequency increased significantly, from 49% to 80% prescribing 15+ times/month during the pandemic.
  • Facilitators included pharmacist knowledge, social influences, perceived rewards, prescribing decision tools, and supportive organizational culture.
  • Barriers comprised environmental context, fear of negative outcomes, and pressure to meet patient demand in busy settings.

Conclusions:

  • Pharmacist prescribing has seen substantial growth.
  • Environmental supports, government funding, peer support, and public awareness are crucial for optimizing and implementing these practice changes effectively.