Mantzourani Efi, Deslandes Rhian, Hodson Karen, Evans Andrew, Taylor Lydia, Lucas Cherie
Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales, UK.
Primary Care, Digital Health and Care Wales, NHS Wales, Cardiff, Wales, UK.
Integr Pharm Res Pract. 2023 Jan 27;12:11-23. doi: 10.2147/IPRP.S395322. eCollection 2023.
A pilot Independent Prescribers' Service (IPS) was introduced in 13 community pharmacies across Wales in June 2020. Independent Pharmacist Prescribers (IPPs) could prescribe in the areas of management of acute conditions, contraception, or opioid withdrawal, as agreed with local commissioners. Access to the patients' medical records was provided via , the national community pharmacy IT platform.
To explore the experiences of IPPs delivering the service and commissioners responsible for financial resources regarding the IPS in Wales.
A qualitative methodology was employed, with purposive sampling, semi-structured interviews, and inductive thematic analysis.
Five themes were constructed from 13 interviews (n=9 IPPs; n=4 commissioners): (i) patient experience and safety; (ii) professional enablement and rebalancing workload of GPs; (iii) role and limitations of remote consultations; (iv) funding and business model; (v) functionality on to support patient care. The design of the service allowed pharmacists to determine how best to deliver the IPS, maximizing access for patients and promoting a sense of professional value amongst pharmacists.
This study builds on the body of evidence on enhanced patient experience with prescribing services in the community, reinforcing that IPPs have a key role in rebalancing management of common conditions from GP surgeries to community pharmacies. Several considerations need to be addressed to ensure future success of the service implementation, delivery and enhanced sustainability, such as formal referral pathways and access to medical records. These can be used by other commissioning bodies in the UK and internationally to build a network of suitably supported IPPs, confident to appropriately deal with uncomplicated acute and chronic conditions; and liaise with primary and/or secondary care when referrals are needed.
2020年6月，威尔士的13家社区药房引入了试点独立处方服务（IPS）。独立药剂师处方者（IPP）可在与当地医疗服务专员商定的急性病症管理、避孕或阿片类药物戒断等领域开出处方。通过国家社区药房信息技术平台可获取患者的病历。
探讨在威尔士提供该服务的IPP以及负责该服务资金的专员的经验。
采用定性研究方法，进行目的抽样、半结构化访谈和归纳主题分析。
通过13次访谈（9名IPP；4名专员）构建了五个主题：（i）患者体验与安全；（ii）专业赋能与全科医生工作量的重新平衡；（iii）远程会诊 的作用与局限性；（iv）资金与商业模式；（v）支持患者护理的功能。该服务的设计使药剂师能够确定提供IPS的最佳方式，最大限度地为患者提供服务，并提升药剂师的职业价值感。
本研究以社区处方服务提升患者体验的证据为基础，强化了IPP在将常见病症管理从全科医生诊所重新平衡至社区药房方面的关键作用。为确保该服务实施、提供及增强可持续性的未来成功，需要解决若干问题，如正式转诊途径和获取病历的问题。英国及国际上的其他委托机构可利用这些经验建立一个得到适当支持的IPP网络，使其有信心妥善处理简单的急性和慢性病症；并在需要转诊时与初级和/或二级医疗服务机构进行联络。
