57 research outputs found
A study of the development of frameworks of pharmacist prescribing in Qatar.
Get PDFSeveral countries across the world have developed and implemented frameworks of non-medical prescribing. In the United Kingdom, pharmacist prescribing was introduced in 2003 as supplementary prescribing, with this extended to include independent prescribing in 2006. Pharmacist prescribing has been proven to be safe, clinically appropriate, and highly regarded by patients and other members of the healthcare team. In Qatar, pharmacy practice is rapidly evolving in an attempt to better utilise pharmacists' skills and thus improve patient health outcomes. Qatar National Vision 2030 aims to establish "a comprehensive world-class healthcare system whose services are accessible to the whole population". To facilitate achievement of this goal, there is potential for the development and implementation of frameworks of pharmacist prescribing in Qatar. The overall aim of this doctoral research was to explore the development of pharmacist prescribing frameworks in Qatar. A multi-modal research design was implemented across four phases with the findings of each phase informing the next. The first phase was an umbrella review of published systematic reviews on non-medical prescribing. Seven systematic reviews reported aspects of prescribing decision-making, processes of prescribing, barriers, and facilitators to implementation. Three of the reviews explored patient outcomes that were noted to be equivalent to or better than physician prescribing. Given the absence of systematic reviews of views and experiences of key stakeholders, the second phase was a systematic review of 65 studies to address this gap in knowledge. The majority of studies pre- and post-implementation reported positive findings. One key limitation of the studies was the general lack of any consideration for theories of implementation in study design, execution, and reporting. The third phase was grounded in the Consolidated Framework of Implementation Research, involving semi-structured qualitative interviews with key stakeholders in positions of power and influence in Qatar. Data saturation was achieved on completion of 37 interviews, the findings of which highlighted support for the development and implementation of pharmacist prescribing in Qatar, with many potential benefits described. Findings of all three phases were incorporated into a final phase Delphi study aiming to determine the levels of agreement amongst key stakeholders in Qatar around the development of pharmacist prescribing frameworks. The scope of the developed framework included: definitions, models and scope of prescribing; education and training; prescribing practice and governance. High levels of agreement were achieved for Delphi statements relating to the Collaborative Pharmacist Prescribing model, thus indicating it as being the most appropriate for Qatar. In conclusion, this research has provided original, robust and rigorous findings which can support implementation of frameworks of pharmacist prescribing in Qatar and beyond. Further research-based developmental work is required to translate this framework into an approved education and training course and practice.This research programme was carried out in collaboration with Qatar University and the Hamad Medical Corporation, Qatar
A scoping review of the integration of non-medical prescribing for acute common clinical conditions by community pharmacists
No full textIt was a big learning experience because they were real patients: an exploration of pre-registration pharmacist trainee views and perceptions of the involvement of patients and carers sharing their experiences as part of undergraduate training.
Get PDFThis poster describes a project that aimed to explore how pharmacy students felt about the involvement of patients and their carers in the delivery of pharmacy education at RGU's School of Pharmacy and Life Sciences
They wanted to know what it was like through my eyes: patients and carers views, experiences, and perceptions of active involvement in the delivery of an undergraduate pharmacy curriculum.
Get PDFIntroduction: There is an increasing policy and practice imperative for involving patients and carers in health-related undergraduate courses. The School of Pharmacy and Life Sciences at Robert Gordon's University, United Kingdom launched a module where patients and carers are actively involved in the delivery of the curriculum by sharing their experiences of their condition and its management with final year student pharmacists. This study aimed to evaluate this initiative by exploring patients' and carers' views and experiences of their active involvement in the delivery and their perceptions of potential future involvement in the design of the pharmacy curriculum. Methods: Face-to-face semi-structured interviews were carried out with patients and carers who were actively involved in the delivery of the pharmacy course. The interview schedule was developed based on the research aim, an extensive literature review, and peer discussion before it was piloted. All interviews were digitally recorded and thematically analysed by two independent researchers. Results: Seven of eight patients and carers involved in the module agreed to be interviewed. Five themes were identified: reasons for engagement with active teaching, perceived impact of active teaching on students, perceived impact of active teaching on patients and carers themselves, perceived opportunity to improve care of future patients, and challenges and suggestions for improvement. Conclusions: Overall, patients and carers had a positive view of their active involvement with delivering the undergraduate pharmacy curriculum; they were however unsure about involvement in curriculum design
Addressing social determinants of health in the wake of the COVID-19 pandemic: urgent need to consider policy and practice in relation to pharmacy's contribution.
Get PDFWorld Health Organization reports highlight health inequalities and social determinants of health (SDoH), and the need for their consideration in strategic health plans. The coronavirus pandemic has exacerbated these issues and government imposed COVID-19 restrictions may have prolonged healthcare consequences including effects on SDoH. Seventy percent of health outcomes are attributable to socio-economic factors, whereas medical care accounts for only 10%-15%. There should therefore be a focus on upskilling all health and social care practitioners. Clinical pharmacists are uniquely positioned to contribute to reducing health disparities, but current foci are around upstream interventions such as addressing polypharmacy and deprescribing. Given the "positive care law" for pharmacy, with high accessibility to services even in deprived areas, social prescribing training and intervention pathways could have significant impact. Limited evidence shows there is enthusiasm for this but there is a need for further research to influence policy and practice including: pharmacy roles, training needs, intervention and evaluation of impact
They wanted to know what it was like through my eyes: patients' and carers' views and experiences of active involvement in the delivery and design of an undergraduate pharmacy curriculum.
Get PDFThis poster describes a project that aimed to explore how patients and their carers felt about being involved in the delivery and future design of pharmacy curricula at RGU's School of Pharmacy and Life Sciences
Pharmacy and medical student interprofessional education placement week.
Get PDFDeveloping collaborative practice through interprofessional education (IPE) activities in undergraduate healthcare curricula is advocated by the World Health Organisation and the regulatory bodies for Medicine and Pharmacy within the UK. Our local faculty, comprising educators from within the Highland Pharmacy Education and Research Centre (HPERC), and Highland Medical Education Centre (HMEC), developed a 5-day IPE placement for pharmacy and medical students on clinical placement within NHS Highland. We collected qualitative evaluation data using face-to-face focus group discussions with five pharmacy and four medical students (January 2020 cohort). Three key categories and multiple themes within each category were identified from participant narratives: Category 1, overall perception of experience (themes: better than previous IPE experience; greater exposure to clinical pharmacy); Category 2, student interactions (themes: learning with a buddy; understanding of interprofessional roles); Category 3, suggestions for improvement (themes: choice of relevant clinical rotation and content; increase learning from clinical pharmacists; better orientation to placement). Overall, students valued their participation during this week and reported many benefits of learning with students from another profession. Students also highlighted suggestions to improve their learning experience. This evaluation has indicated students' support for embedding interprofessional placements into their curricula. Clinical educators should consider designing similar placements, while further work should focus on inclusion of higher student numbers and look to include a range of professions and practice settings
A scoping review of evidence of community pharmacist independent prescribing for common clinical conditions: beyond protocol prescribing
No full textPharmacist independent prescribers (PIPs) enhance patient care but there is variability in their integration in community pharmacy (CP). The objective was to collate and characterise literature on the integration of 'standard of care' model PIPs in CP for acute common clinical conditions (CCC). This review followed the Arksey and O'Malley framework. Eligibility criteria, search databases and terms were defined. Information sources were searched from January 2006 to October 2023. Following screening, full text review and data extraction a narrative synthesis approach was used to address the review objectives. All steps were independently checked by two of the review team. Barriers and facilitators for integration used the Consolidated Framework for Implementation Research as a theoretical lens. Ten papers remained for full text review from 1075 records. Most studies were from Canada and focused on pharmacist views, evaluation of safety, effectiveness and patient satisfaction. A range of CCCs were included with a focus on antimicrobial prescribing. A wide range of barriers and facilitators to implementation were identified; 'regulatory constraints' and 'fiscal challenges' at a macro socio-organisational level and several challenges within organisations; lack of clarity on the pharmacists' scopes of practice and linked consumer confusion, staffing levels and workload with specific mention of paperwork and access to patient records. Most evidence for CCC management by PIPs relates to antimicrobials, originates in Canada and identifies multiple challenges. Given this there is a need to consider this topic further to identify ways to address the challenges and facilitate integration of PIPs in CP
Stakeholders' views and experiences of pharmacist prescribing: a systematic review.
Get PDFWhile prescribing has been traditionally been the domain of physicians, prescribing by pharmacists has been implemented successfully in countries across the world. Developments are supported by evidence of effectiveness and safety. To facilitate further development and implementation, there is a need to review the evidence of views and experiences of stakeholder groups both pre- and post-implementation. The aim of this review is to critically appraise, synthesise and present the available evidence on the views and experiences of stakeholders pre- and post-implementation of pharmacist prescribing globally. Setting and Method: A systematic review protocol was developed according to the PRISMA_P standards and registered on the PROSPERO database at the Centre for Reviews and Dissemination. Search databases were MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Pharmaceutical Abstracts, PsychArticles, and Google Scholar with no date limits. Studies selection, quality assessment and data extraction were conducted independently by at least two reviewers. A narrative approach to data synthesis was undertaken due to heterogeneity of study outcome measures. Main outcome measures: Views and experiences around pharmacist prescribing as well as the facilitators and barriers to its development and implementation. Results: Sixty-three studies were included in the review. The UK was the main country studies (n=34) compared to Australia (n=13), USA (n=5), Canada (n=5), Nigeria (n=3), New Zealand (n=1), Ireland (n=1) and India (n=1). In addition, different stakeholders were researched. The majority of papers investigated perceptions and views of pharmacists (n=25) while few discussed patients (n=12), general practitioners (n=6), the public (n=4), nurses (n=1), policy makers (n=1) or had multiple stakeholders (n=14). Positive findings were reported by the majority of studies. The main benefits described were improved access to healthcare services and patients' outcomes, better utilisation of pharmacists' skills and knowledge, improved job satisfaction and reduced physicians' workload. Lack of support for this role reported was mainly due to liability issues, poor pharmacists' diagnosis skills and access to medical records and lack of organizational and financial support. Conclusion: There is an accumulation of evidence around improving healthcare delivery and patients' outcomes with the introduction of competent pharmacist prescribers. While there may be issues to resolve such as liability and financial considerations, these findings may support developments of pharmacist prescribing
Future perspectives on nonmedical prescribing
Get PDF Many countries have implemented nonmedical prescribing (NMP) and many others are scoping prescribing practices with a view to developing NMP. This paper provides a future perspective on NMP in light of findings of an umbrella review of aspects of NMP. This is followed by coverage of the Scottish Government strategy of pharmacist prescribing and finally, consideration of two key challenges. The review identified seven systematic reviews of influences on prescribing decision-making, processes of prescribing, and barriers and facilitators to implementation. Decision making was reported as complex with many, and often conflicting, influences. Facilitators of NMP included perceived improved patient care and professional autonomy, while barriers included lack of defined roles and resource pressures. Three systematic reviews explored patient outcomes that were noted to be equivalent or better to physician prescribing. In particular, a Cochrane review of 46 studies of clinical, patient-reported, and resource-use outcomes of NMP compared with medical prescribing showed positive intervention-group effects. Despite positive findings, authors highlighted high bias, poor definition and description of ‘prescribing’ and the ‘prescribing process’ and difficulty in separating NMP effects from the contributions of other healthcare team members. While evidence of benefit and safety is essential to inform practice, for NMP to be implemented and sustained on a large scale, there needs to be clear commitment at the highest level. The approach being taken by the Scottish Government to pharmacist prescribing implementation may inform developments in other professions and countries. The vision is that by 2023, all pharmacists providing pharmaceutical care will be pharmacist-independent prescribers. There are, however, challenges to implementing NMP into working practice; two key challenges are the need for sustainable models of care and evaluation research. These challenges could be met by considering the theoretical basis for implementation, and robust and rigorous evaluation. </jats:p
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