Prescription modifications by pharmacists and their views on potential prescribing authority: a nationwide survey

In several countries, pharmacists have gained prescribing authority to enhance the quality and accessibility of healthcare. Elsewhere, pharmacists initiate or modify prescriptions that are subsequently countersigned by a prescriber, potentially serving as a stepping stone toward formal prescribing legislation. This study aimed to investigate current prescription modifications by Dutch pharmacists and their views on introducing prescribing authority.

A nationwide cross-sectional survey was conducted among pharmacists in the Netherlands via national professional networks in April and May 2024. The questionnaire assessed current prescription modification practices, pharmacists' agreement regarding the introduction of formal prescribing authority, and their perceived needs and readiness for prescribing. Data were analysed using descriptive statistics.

Among the 476 respondents, most worked in community pharmacy (76.7%; n = 365), followed by inpatient hospital pharmacy (14.7%; n = 70). The two most common prescription modifications were adjusting or initiating prescriptions based on clinical decision rules (81.1%; n = 386), and performing therapeutic substitution during drug shortages or according to local formularies (79.6%; n = 379). Almost all respondents favoured formal prescribing authority for at least one prescription modification practice (98.1%; n = 467). Respondents most often indicated clear task division and agreements between physicians and pharmacists (93.9%, n = 447) as a need for implementation. Readiness to use prescribing authority was reported by 92.6% (n = 441) of the respondents.

The majority of pharmacists frequently initiate or modify prescriptions, and expressed both willingness and readiness to formalize these practices. These findings are valuable for policymakers considering the introduction of formal pharmacist prescribing authority.