The Pharmaceutical Journal
Vol 280 No 7495 p354
29 March 2008

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Apathy may undermine supplementary prescribing

Medical apathy and the introduction of independent prescribing may undermine the success of supplementary prescribing, according to a study published in Health Policy this month (2008;85:277).

Richard Cooper, a research fellow at the school of pharmacy, University of Nottingham, and colleagues conducted a review of the nursing and pharmacy supplementary prescribing literature — empirical research and grey literature — from 1997 to 2007. They found that nurse and pharmacist supplementary prescribers were positive and generally confident about non-medical prescribing and that it has been successfully implemented in a range of settings. However, they also discovered that doctors are more critical of the development and lack awareness and understanding of it.

Several underlying tensions became evident during the review, say the researchers. For example, training needs and existing competencies differ among pharmacists and nurses, suggesting that educational reviews of joint courses may be needed. The researchers also propose that a review of the clinical management plan may be necessary to make it more flexible and quicker to set up and use.

The researchers question whether, because of its inflexibility, supplementary prescribing will become viewed as simply a transitional prescribing model providing newly qualified non-medical prescribers with confidence before prescribing independently. “This may have significant policy implications for the commissioning and funding of non-medical prescribing services,” they comment.

During the review, the authors identified a lack of research in several areas, including patients’ experiences of supplementary prescribing, patient safety and the economic or NHS cost implications of supplementary prescribing.

They suggest that methodologically robust research that focuses on key concerns such as patient safety and economic outcomes is urgently needed to inform the implementation of supplementary prescribing.