Script Shift: South African pharmacists' knowledge and perspectives of e-prescribing

This study explored the knowledge and perceptions of pharmacists in Gauteng, South Africa, regarding electronic prescribing implementation. As South Africa commences digital transformation in healthcare, this study identifies factors that will facilitate implementation and barriers that will hinder e-prescribing adoption, the findings which may contribute to policy reform. A mixed-methods study using a self-administered questionnaire was used to assess pharmacists' knowledge and perception of electronic prescribing and distributed through email to pharmacists (n = 386). Knowledge and perceptions were measured using a 5-point Likert-scale, where percentage scores were categorized as per Bloom's cutoff point as follows: poor: (<60%), moderate: (60%-79%), good: (≥80%) for knowledge and negative (<60%), neutral (60%-79%), or positive (≥80%) for perceptions. A pilot study (n = 50) was conducted to assess reliability. Quantitative data were analyzed using descriptive statistics and ordinal regression, with significance set at P < 0.05. Thematic analysis was applied to qualitative responses, using an inductive and deductive approach. Integration of the quantitative and qualitative findings in the discussion ensured triangulation of the results. Pharmacists demonstrated moderate knowledge of e-prescribing (60%-79%) and positive perceptions of its usefulness (≥80%). Higher knowledge of e-prescribing was associated with positive perceptions (P < 0.001). Predictors for good knowledge include recently graduated pharmacists (P = 0.010), while pharmacists in management positions had 2.88 higher odds of perceiving e-prescribing as appropriate for the workplace (P = 0.001). Thematic analysis revealed four themes: the benefits of e-prescribing, software design recommendations, facilitators for implementation, and barriers to adoption. Key facilitators included education and training, and a standardized regulatory framework aligned with international standards. Resistance to adoption stemmed from poor knowledge, infrastructural and financial constraints. This study concludes that while pharmacists support electronic prescribing, addressing regulatory, financial, and infrastructural challenges will promote successful implementation.