How does the situation on pharmacist prescribing in Australia compare with other English-speaking countries?
Australia continues to lag behind other English-speaking countries in the introduction of pharmacist prescribing models, potentially reducing access to primary health care and chronic illness treatment, researchers said.
Legislation supporting pharmacist prescribing has been implemented in the UK, Canada and New Zealand, but to date prescribing rights have not been extended to Australian pharmacists.
This is despite prescribing rights being extended to a range of other professions in Australia, including nurse practitioners, midwives, dentists, podiatrists and optometrists, said the authors of a recently published literature review.
Pharmacist prescribing has been a hot topic in Australia this year following the Pharmacy Board’s release of a discussion paper on the topic, and calls for movement in this area from pharmacy leaders.
Unsurprisingly, responses from doctor groups questioned the health outcomes from such a move.
Now, researchers from the Australian National University, Canberra, and other institutions, examined 64 peer-reviewed and grey literature articles on pharmacist prescribing from these three countries and Australia. They analysed the barriers listed in each of these topics, and the relationship to an Australian context.
Among the commonly identified barriers to pharmacist prescribing are:
- Reservations from other health professions, especially GPs
- Inadequate support for the concept from health authorities, employers and pharmacists themselves
- The lack of a prescribing model for pharmacists was mentioned especially in Australian research as being a perceived barrier
- Poor awareness of models, including working overseas models, among stakeholders. This included one Australian study finding pharmacists themselves weren’t aware of examples of pharmacist prescribing in other countries.
- Potential conflicts of interest between multiple pharmacist role – especially of compromise from commercial concerns in the shared roles of prescribing and retail
Surprisingly encroachment on GP turf was not mentioned in Australian literature but had been mentioned in the UK and Canada.
“Many barriers,,, described reflect that pharmacists do not traditionally have a role in clinical diagnosis and treatment,” the authors said.
“Hence, resistance to their roles as prescribers is unsurprising.”
Three major gaps exist in research on pharmacist prescribing in an Australian context, the authors said. These are:
- Policy development and implementation planning
- Further exploration of the perceptions of key stakeholders about acceptance and feasibility
- Developing well-designed prescription training courses
“A concerted effort is required to develop clear policy pathways, including targeted training courses, raising stakeholder recognition of pharmacist prescribing, and identifying specific funding, infrastructure and other resourcing needs to ensure the smooth integration of pharmacist prescribers within interprofessional teams,” the authors said.
“Further research focusing on policy development and implementation in the Australian context will be essential,” they concluded.
The research was published in the International Journal of Pharmacy Practice