Supplementary prescribing could fragment care
Supplementary prescribing by pharmacists risks fragmenting patient care, according to a report published this week.
The report, commissioned from researchers at the University of Bath by
the Pharmacy
Practice Research Trust, says that supplementary prescribing
encourages greater use of pharmacists’ skills, but could fragment
patient care if pharmacists run single condition disease management clinics,
such as hypertension clinics.
“Patients with multiple conditions may be disadvantaged in this
supplementary prescribing model and need to consult multiple prescribers
for different
aspects of their clinical care,” the authors say. “In this
sense, supplementary prescribing can be seen as being at odds with patient-centred
care and a patient-led NHS, instead being designed around the health
care system and the capabilities of different professional groups,” they
add.
University of Bath researchers Marjorie Weiss, Jane Sutton and Catherine
Adams initially interviewed a number of pharmacist supplementary prescribers
and subsequently interviewed doctors, pharmacists, other health professionals,
administrators and patients. They also observed patient consultations
with pharmacist supplementary prescribers.
The authors warn that both patients and other health professionals have
a general lack of awareness and understanding of the supplementary prescribing
role. They add that good communication between health professionals and
between professionals and patients is essential if supplementary prescribing
is to work in practice.
They also say that pharmacists who train as supplementary prescribers
should have to retrain if they have not started to work as supplementary
prescribers within one year.
Despite these misgivings, the report concludes that pharmacist supplementary
prescribers are overwhelmingly in favour of the role and that in several
settings it works well. Clear lines of communication and responsibility
distinguished such settings.
They said: “For supplementary prescribing to be effective, there
needs to be support for training and support for the practical processes
that make supplementary prescribing work at ground level.”
Royal Pharmaceutical Society President Hemant Patel said: “Prescribing
by pharmacists represents an enormous opportunity for the profession.
The Society is actively working to support pharmacists and to encourage
them to engage with this crucial new development. More work is under
way. A key element will be to communicate with the public and local commissioners
on the benefits to be gained.” |
The
Pharmaceutical Journal
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