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Pharmacist prescribing benefits both patients and the health care system by improving access to care, leading to more appropriate referrals and medication use, and reducing health system costs.
Pharmacy practice in Nova Scotia has changed significantly since pharmacist prescribing was first introduced in 2011. Recent years have seen increased government funding for pharmacist prescribing, the introduction and expansion of pharmacist-led primary care clinics, and increasing public demand for care from pharmacists, particularly since the COVID-19 pandemic.
We studied pharmacists’ experience with prescribing to better understand how to support pharmacist prescribing within this rapidly evolving practice environment.
What we did
First, we surveyed community pharmacists in Nova Scotia to ask about their prescribing activities before and during the COVID-19 pandemic, perceptions of their prescribing role, and things that help (facilitators) or hinder (barriers) prescribing (published previously). Second, we interviewed community pharmacists in Nova Scotia to learn more about how often they prescribe, their prescribing activities, and their practice environment. The interviews added context and enriched our understanding of the barriers and facilitators of pharmacist prescribing. Behaviour change theory guided our work, and informed the development of change strategies—actions that can be taken to support pharmacist prescribing.
What we learned
- Pharmacist prescribing is now common in Nova Scotia, and is an increasingly important access point for primary care. This creates new opportunities to help patients and more appropriately distribute patient care needs across the health care system, but also creates considerable challenges.
- Significant barriers to pharmacist prescribing remain, including challenges in the pharmacy environment like lack of time and/or difficulty or inability to access patient records. Alongside this, there are often unrealistic expectations from the public as pharmacies have traditionally been very accessible and new models for clinical care, like prescribing, takes more time.
- Facilitators of prescribing include pharmacists’ desire to help patients, access to decision aids, supportive organizational cultures, and the integration of pharmacists into the health care system.
Implications
- Pharmacist prescribing takes more than pharmacists. There are many groups with a role to play including pharmacists, pharmacy owners/managers, educators, advocacy bodies, regulators, and government.
- The change strategies that we identified represent actions that can be taken to shift how care provided by pharmacists is supported by the system and the public. These actions are designed to address the barriers and facilitators and tailored to each group.