Donovan Jacqueline, Tsuyuki Ross T, Al Hamarneh Yazid N, Bajorek Beata
Graduate School of Health (Pharmacy) (Donovan, Bajorek), The University of Technology Sydney, Broadway, NSW, Australia.
Faculty of Medicine and Dentistry (Tsuyuki, Al Hamarneh), University of Alberta and EPICORE Centre (Tsuyuki, Al Hamarneh), Edmonton, Alberta.
Can Pharm J (Ott). 2019 Aug 6;152(5):317-333. doi: 10.1177/1715163519865759. eCollection 2019 Sep-Oct.
To describe primary care pharmacists' current scope of practice in relation to laboratory testing.
A 2-tiered search of key databases (PubMed, EMBASE, MEDLINE) and grey literature with the following MeSH headings: . We focused on Canada, the United States, the United Kingdom, New Zealand and Australia for this review.
There is limited literature exploring primary care pharmacists' scope of practice in relation to laboratory testing. The majority of literature is from the United States and Canada, with some from the United Kingdom and New Zealand and none from Australia. Overall, there is a difference in regulations between and within these countries, with the key difference being whether pharmacists access and/or order laboratory testing dependently or independently. Canadian pharmacists can access and/or order laboratory tests independently or dependently, depending on the province they practise in. US pharmacists can access and/or order laboratory tests dependently within collaborative practice agreements. In the United Kingdom, laboratory testing can be performed by independent prescribing pharmacists or dependently by supplementary prescribing pharmacists. New Zealand prescribing pharmacists can order laboratory testing independently. Most publications do not report on the types of laboratory tests used by pharmacists, but those that do predominantly resulted in positive patient outcomes.
DISCUSSION/CONCLUSION: Primary care pharmacists' scope of practice in laboratory testing is presently limited to certain jurisdictions and is often performed in a dependent fashion. As such, a full scope of pharmacy services is almost entirely unavailable to patients in the United States, the United Kingdom, New Zealand and Australia. Just as in the case for pharmacists prescribing, evidence indicates better patient outcomes when pharmacists can access/order laboratory tests, but more research needs to be done alongside the implementation of local guidelines and practice standards for pharmacists who practise in that realm. Patients around the world deserve to receive a full scope of pharmacists' practice, and lack of access to laboratory testing is one of the major obstacles to this. 2019;152:xx-xx.
描述基层医疗药师在实验室检测方面当前的执业范围。
对主要数据库（PubMed、EMBASE、MEDLINE）和灰色文献进行两级检索，使用以下医学主题词：……。本综述聚焦于加拿大、美国、英国、新西兰和澳大利亚。
探索基层医疗药师在实验室检测方面执业范围的文献有限。大多数文献来自美国和加拿大，有一些来自英国和新西兰，没有来自澳大利亚的。总体而言，这些国家之间以及国家内部的法规存在差异，关键差异在于药师获取和/或订购实验室检测是独立进行还是依赖他人。加拿大药师可根据其执业所在省份独立或依赖他人获取和/或订购实验室检测。美国药师可在协作实践协议范围内依赖他人获取和/或订购实验室检测。在英国，实验室检测可由独立开处方的药师进行，或由补充开处方的药师依赖他人进行。新西兰开处方的药师可独立订购实验室检测。大多数出版物未报告药师使用的实验室检测类型，但那些报告了的大多产生了积极的患者结果。
讨论/结论：基层医疗药师在实验室检测方面的执业范围目前仅限于某些司法管辖区，且通常以依赖的方式进行。因此，在美国、英国、新西兰和澳大利亚，患者几乎完全无法获得全面的药学服务。正如药师开处方的情况一样，有证据表明当药师能够获取/订购实验室检测时，患者结果会更好，但在实施针对该领域执业药师的当地指南和实践标准的同时，还需要进行更多研究。世界各地的患者都应该获得全面的药师服务，而无法进行实验室检测是实现这一目标的主要障碍之一。2019年；152：xx - xx。
