Clinical Pharmacy and Pharmacy Practice Department, Cairo University, Kasr El-Aini, Egypt.
Res Social Adm Pharm. 2011 Sep;7(3):246-56. doi: 10.1016/j.sapharm.2010.05.002. Epub 2010 Jul 23.
Supplementary prescribing (SP) is a drug therapy management model implemented in the United Kingdom since 2003. It is a voluntary partnership between an independent prescriber; a supplementary prescriber, for example, nurse or pharmacist; and the patient, to implement an agreed patient-specific clinical management plan (CMP).
To investigate pharmacist prescribers' views and experiences of the early stages of SP implementation.
A qualitative, longitudinal study design was used. A purposive, maximum variability sample of 16 pharmacist supplementary prescribers, trained in Southern England, participated. Eleven were hospital pharmacists, owing to the overrepresentation of hospital pharmacists in the first cohort. Two semistructured interviews were conducted with each participant, at 3 and 6 months after their registration as prescribers. The Framework approach was used for data collection, management, and analysis.
Three typologies of pharmacists' experiences were identified: "a blind alley", "a stepping stone" and "a good fit". Despite some delays in its implementation, SP was seen as a step forward. Some participants also believed that it improved patient care and pharmacists' integration in the health care team and increased their job satisfaction. However, there was a concern that SP, as first implemented, was bureaucratic and limited pharmacists' freedom in their decision making. Hence, pharmacists were more supportive of the then imminent introduction of a pharmacist independent prescribing (IP) role.
Despite challenges, the SP role represented a step forward for pharmacists in the United Kingdom. It is possible that pharmacist SP can coexist with IP in the areas suitable for CMP use. Elsewhere, SP is likely to become more of a "stepping stone" to an IP role than the preferred model for pharmacist prescribing. Future research needs to objectively assess the outcomes of pharmacist SP, preferably in comparison with IP, to inform decision making among pharmacists regarding the adoption of such an innovative role.
补充处方（Supplementary prescribing，SP）是自 2003 年以来在英国实施的一种药物治疗管理模式。它是一种独立处方医师与补充处方医师（例如护士或药剂师）和患者之间的自愿合作关系，以实施商定的特定于患者的临床管理计划（CMP）。
调查药剂师处方者对 SP 实施早期阶段的看法和经验。
采用定性、纵向研究设计。在英格兰南部接受培训的 16 名药剂师补充处方者参与了一项有目的、最大变化的样本研究。由于第一队列中医院药剂师人数过多，其中 11 人是医院药剂师。在注册为处方者后的 3 个月和 6 个月，对每位参与者进行了两次半结构化访谈。使用框架方法进行数据收集、管理和分析。
确定了三种药剂师经验的类型学：“死胡同”、“踏脚石”和“契合”。尽管实施过程中存在一些延误，但 SP 被视为向前迈出的一步。一些参与者还认为，它改善了患者护理和药剂师在医疗保健团队中的整合，并提高了他们的工作满意度。然而，有人担心，最初实施的 SP 过于官僚化，限制了药剂师在决策中的自由。因此，药剂师更支持即将推出的独立处方（IP）角色。
尽管存在挑战，但 SP 角色代表了英国药剂师的一个进步。在适合 CMP 使用的领域，药剂师 SP 可能与 IP 并存。在其他地方，SP 可能更像是通向 IP 角色的“踏脚石”，而不是药剂师处方的首选模式。未来的研究需要客观评估药剂师 SP 的结果，最好与 IP 进行比较，为药剂师在采用这种创新角色方面的决策提供信息。
