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Exploring the potential for pharmacist prescribing in the management of hypertension in primary care: an Australian survey
Author(s) -
Bajorek Beata,
Krass Ines
Publication year - 2017
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/jppr.1218
Subject(s) - medicine , pharmacist , family medicine , accreditation , psychological intervention , clinical pharmacy , primary care , scope of practice , medline , drug utilization review , deprescribing , intervention (counseling) , medical prescription , health care , nursing , pharmacy , intensive care medicine , polypharmacy , medical education , political science , law , economics , economic growth
Background The management of hypertension, particularly medicines use, remains suboptimal and pharmacist‐delivered models of care may assist clinicians in this regard. Aim The primary objective of this study was to explore the potential for pharmacists to make treatment recommendations and prescribing decisions for patients with hypertension. Method Accredited (medicines review) pharmacists working in the primary care setting within the Sydney metropolitan area ( NSW , Australia) were recruited. Pharmacists completed a scenario‐based survey that asked them to demonstrate a simulated prescribing function in the management of 6 patient scenarios. The management of the scenarios was assessed from the pharmacists’ perspective (i.e. usefulness of prescribing, confidence in prescribing) and by an expert clinical panel (i.e. clinical appropriateness). Results Thirty pharmacists (27.4 ± 10.7 years in practice) participated. Most pharmacists indicated that a prescribing function would be useful within their scope of practice and that they would be confident in executing this as an intervention. The expert clinical panel rated the vast majority of recommendations by pharmacists to be appropriate. Ratings for usefulness of, confidence in and appropriateness of the prescribing recommendations were lowest for the 2 scenarios depicting more complex cases; here the level of agreement among the expert panel was also poor (κ ≤ 0.15). Recommendations relating to processes for assessing patients were rated relatively lower, particularly for the complex scenarios. Conclusion Accredited pharmacists have the capacity and potential for a prescribing function to help optimise hypertension management. Simulated prescribing interventions undertaken by accredited pharmacists were assessed as clinically appropriate by medical clinicians.