Preparing for pharmacist prescribing in Maltese hospitals

Abstract

Objectives: To develop and evaluate a framework for pharmacist prescribing in a hospital setting, assess differences between pharmacist and physician prescribing and analyse pharmacist perceptions on pharmacist prescribing. Methods: A framework for pharmacist prescribing in hospital based on a collaborative drug therapy management approach was developed. Guidelines on three therapeutic scenarios, namely oral anticoagulation therapy, hypertension and diabetes mellitus, were compiled as part of the framework. The framework was validated by an expert panel consisting of five pharmacists and four physicians. A self-administered questionnaire was developed and distributed to the expert panel to evaluate the framework. A case study relating to each therapeutic scenario identified was designed and given to the expert panel to assess differences between pharmacist and physician prescribing. The framework and the questionnaire were disseminated to all 62 pharmacists practicing in local public hospitals to evaluate the framework and their perceptions on pharmacist prescribing. Key findings: All nine expert panel members strongly agreed or agreed that the proposed framework is well-presented, clear and comprehensive, and seven strongly agreed or agreed upon its practicality for use in the hospital setting. Results of the case studies showed that pharmacists and physicians prescribed similar treatment when the correct diagnosis was established. Of the 31 pharmacists who completed the questionnaire, more pharmacists were willing to prescribe antihypertensive (n = 27) and antidiabetic medications (n = 27) compared to oral anticoagulation therapy (n = 20). Twenty-seven pharmacists recommended further education to a specialised Masters or Doctorate level for pharmacist prescribing. Conclusions: The proposed framework puts forward a well-presented, comprehensive and practical system to prepare pharmacists for pharmacist prescribing in a hospital setting within a multidisciplinary team practice for chronic conditions.