Clinical pharmacists' aspirations on prescribing in cardiology within an academic health system

Pharmacist prescribing in cardiology is influenced by clinical expertise, organizational structures, and expanding scopes of practice. Although international models highlight the value of pharmacist prescribers, limited evidence describes how prescribing is experienced within cardiology pharmacy practice. This study examined the prescribing potential, contextual conditions, and motivations of clinical pharmacists as part of continuing professional development.

An interview-based qualitative design informed by collective autoethnography was used to situate researchers' professional experiences and reflections. Data were derived from retrospective reflections of clinical pharmacists and a pharmacy student working within an academic health system in the United Arab Emirates (UAE). Reflexive thematic analysis, guided by Braun and Clarke's six-phase approach, was conducted with iterative reflexivity and theoretical integration.

Twelve themes were generated from 155 coded excerpts and grouped into three domains: what pharmacists do when prescribing, when prescribing occurs, and why prescribing is undertaken. Prescribing activities included patient assessment, dose adjustment, and initiation of evidence-based cardiovascular therapies. Key enabling conditions were specialized training, interprofessional trust, and collaborative care structures. Motivations centered on enhancing autonomy, improving timely medication optimization, and achieving meaningful patient outcomes.

Pharmacist prescribing in cardiology is a clinically grounded and collaborative practice that suggests potential to support timely therapeutic decisions and reduces treatment inertia. Insights from this insider perspective underscore the need for structured prescribing pathways, advanced training, and supportive regulatory frameworks to enable pharmacists to practice at their full scope.