Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
BMC Health Serv Res. 2010 Nov 17;10:313. doi: 10.1186/1472-6963-10-313.
Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use.
METHODS/DESIGN: We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals.
In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based.
赋予配药药剂师处方权对药品和卫生人力资源政策以及医疗质量具有重要意义。尽管越来越多的司法管辖区赋予药剂师这些特权，但对这些政策变化的严格评估却很少。本研究将考察加拿大不列颠哥伦比亚省（BC）于 2009 年 1 月实施的一项政策变更，该政策允许药剂师独立调整和更新处方。我们假设该政策增加了药物的使用和药物成本，提高了患者对药物的依从性，并减少了总医疗资源的使用。
方法/设计：我们将对 2004 年至 2010 年期间不列颠哥伦比亚省约 400 万居民进行基于人群的队列研究。我们将使用 BC PharmaNet 上的所有数据来获取该队列在研究期间获得的所有处方，并将其与医生的行政账单和医院出院记录相关联。我们将使用中断时间序列分析来研究药物利用和成本、药物依从性以及短期医疗保健利用的纵向变化。此外，我们将使用分层模型来研究与处方调整和更新相关的区域、药房、患者和处方层面的因素。
在最近对加拿大政策制定者的调查中，许多受访者将处方特权问题列为他们最紧迫的政策问题之一。无论我们的研究结果如何，它们对政策制定者来说都很重要，因为我们的数据将使围绕药剂师处方的决策更加基于证据。
