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Area of Science:

  • Pharmacy Practice
  • Health Policy
  • Clinical Pharmacy

Background:

  • Growing healthcare demands and physician shortages necessitate expanded pharmacist roles.
  • Pharmacist prescribing is established in Canada, the UK, and the US, but adoption varies internationally.
  • International models offer insights for expanding pharmacist clinical responsibilities.

Purpose of the Study:

  • To compare international pharmacist roles and prescribing practices.
  • To identify essential competencies for expanded pharmacist functions.
  • To explore implications for global pharmacist role expansion.

Main Methods:

  • Systematic literature search of MEDLINE, CINAHL, and Cochrane Library using PICO framework.
  • Appraisal of 23 studies using Critical Appraisal Skills Programme (CASP) checklists.
  • Thematic synthesis of data following PRISMA 2020 guidelines.

Main Results:

  • Four key themes emerged: expanding roles, regulatory frameworks, inferred competencies (micro-skills and macro-capabilities), and contextual barriers.
  • Pharmacists perceive readiness for expanded roles, but training gaps and workflow challenges exist.
  • Evidence supports pharmacist prescribing as safe and patient-centered under specific conditions.

Conclusions:

  • Pharmacist prescribing requires robust regulation, structured training, and systemic integration for successful implementation.
  • International experiences provide valuable guidance for countries considering expanding pharmacist clinical responsibilities.
  • Optimizing medication management and healthcare access can be achieved through evidence-based pharmacist role expansion.