Confidence, Barriers, and Role Identity of General Practice Independent Pharmacist Prescribers in Northern Ireland

Background: The role of General Practice Independent Pharmacist Prescribers (GPIPPs) has expanded significantly in primary care, with increasing responsibilities in medicines optimisation and chronic disease management. However, gaps remain in understanding their confidence in clinical decision-making, the barriers they face, and their professional identity within multidisciplinary teams. This study aimed to explore GPIPPs' confidence, identify barriers to their prescribing autonomy, and assess the clarity of their role and their support within primary care settings in Northern Ireland. Methods: A cross-sectional study design was employed, combining quantitative and qualitative approaches. Data were collected via a Jisc online questionnaire distributed to GPIPPs working in general practices across Northern Ireland. The questionnaire assessed their demographic information, confidence in clinical decision-making, barriers to prescribing, and professional identity. Qualitative data from open-ended responses were analysed using thematic analysis. Results: Quantitative findings indicated that most GPIPPs viewed clinical decision-making as integral to their role, yet only a few felt adequately prepared by their independent prescribing courses. Qualitative analysis revealed themes such indemnity concerns, insufficient training, role ambiguity, and variability in GP support. Conclusions: The study highlights that while GPIPPs are confident in their prescribing roles, significant barriers such as indemnity concerns, training gaps, and role ambiguity hinder their full potential. Policy-level changes, including clearer indemnity policies, enhanced training programs, and standardised mentorship, are essential to optimise GPIPPs' integration and effectiveness in primary care. Addressing these challenges will ensure that GPIPPs can fully contribute to patient care as autonomous prescribers.