1. Stakeholder views on pharmacist independent prescribers in substance misuse in NHS Lanarkshire
Duncan Hill1,2, Alison Mitchell2, Shona McDonald2, Derna Campbell2
1. NHS Lanarkshire, 2. School of Pharmacy, SIPBS, University of Strathclyde
Introduction NHS Lanarkshire has used pharmacist prescribers since 2004 to deliver substance misuse clinics. The Community Prescribing Service has been redesigned to be an integrated multi-professional team including GP, pharmacist and nurse prescribers. Since the service was initially evaluated in 2011 there have been several changes, both in terms of clinic / patient numbers and staffing. Method Stakeholder opinions of pharmacist prescribers were collected using anonymous questionnaires. Three stakeholder groups within the service were targeted, patients, prescribing pharmacists and medical practitioners, and responses analysed. Results 2016 survey In total there were completed questionnaires in 2016 from 182 patients, eight pharmacists and eight GPs. Patients 94.5% were either satisfied or very satisfied with the venue of the clinic they attended which varied from addiction teams (45.6%), health centre (35.2%), community pharmacy (10.4%) and hospital (8.8%). In relation to appointments, the ease of making appointments scored very high (92.5% easy/very easy), with 98.9% allowing sufficient time for discussions, 97.3% of patients felt involved in the decisions and 95.1% gaining enough information about the condition and medication. Pharmacist Prescribers 50% were NHS contracted pharmacists and 50% were sessional community pharmacists. Caseloads varied from 0 to 190 patients, the average was 61 patients GPs 62.5% found pharmacist prescribing to be very beneficial and 25% beneficial. Comparison 2016 to 2011 results The 2016 study interviewed over twice the number of patients The majority of patients (65.7%) expressed their view that the pharmacist was their preferred prescriber of choice, the preference for a pharmacist was greater than any other professional. The patients reported that the pharmacists were ‘knowledgeable’ and ‘easy to talk to’ 98.9% of patients responded they had sufficient time with their prescriber an increase of 2.9% in comparison with Overall, patients had an exceptionally positive perception of the services provided in NHS Lanarkshire, with 98.8% and 96.2% of patients in the respective 2011 and 2016 studies, rating the service good/very good.
Table 1.Patients views on pharmacist prescribing Pharmacist prescribers All in the 2016 study felt the services they provide were beneficial. In addition, all pharmacists were confident that other members of staff supported them in their role. Table 2. Pharmacist prescribers views on benefits GPs All the GPs (100%) in the 2016 study thought very highly of the pharmacists, commending their competence, clinical knowledge and value that they provide to the service, which demonstrated improvement from the 2011 findings. Responses show all are supportive of the changes and service. There are a great number of similarities in comparison with the 2011 study despite the significant changes and growth experienced by the service in the intervening five years. Conclusion The increased number of pharmacist prescriber clinics and numbers of patients attending has not been detrimental to the high standards and level of acceptability determined by the study from 2011 when repeated in This continued development of using pharmacist prescribers as an integral part of NHS Lanarkshire’s addiction services is seen as valuable and effective. It is the preferred option for many patients, encouraging them to maintain their journey to recovery whilst adding to the prescribers’ job satisfaction.
Question
Result - percentage of pharmacist prescribers in 2011 (n=5)
Result - percentage of pharmacist prescribers in 2016 (n=8)
How beneficial would you say the service you provide is to the patient?
1 - Not beneficial
2 - slightly beneficial
3 - beneficial
4 - quite beneficial
5 - very beneficial
100
Contact: Duncan Hill -