University of the West of England, Blackberry Hill, Stapleton, Bristol, UK.
University of Exeter, Stocker Road, Exeter, UK.
Prim Health Care Res Dev. 2023 Apr 20;24:e28. doi: 10.1017/S1463423623000142.
To explore the experiences of musculoskeletal (MSk) physiotherapy independent prescribing in primary care from the perspectives of physiotherapists and General Practitioners (GPs) and identify the implications these have for contemporary physiotherapy practice in primary care.
Legislative change in the United Kingdom (UK) in 2013 enabled physiotherapists holding a postgraduate non-medicalprescribing qualification to independently prescribe certain drugs that assist in patient management. Independent prescribing by physiotherapists is a relatively contemporary development in role change and purpose, occurring alongside the development of physiotherapy first contact practitioner (FCP) roles in primary care.
A critical realist approach was used, with qualitative data collected via 15 semi-structured interviews with physiotherapists and GPs in primary care. Thematic analysis was applied.
Fifteen participants were interviewed (13 physiotherapists, 2 GPs). Of the 13 physiotherapists, 8 were physiotherapy independent prescribers, 3 were MSk service leads, and 3 were physiotherapy consultants. Participants worked across 15 sites and 12 organisations.
Whilst physiotherapists were empowered by their independent prescribing qualification, they were frustrated by current UK Controlled Drugs legislation. Physiotherapists reported vulnerability, isolation, and risk as potential challenges to independent prescribing, but noted clinical experience and 'patient mileage' as vital to mitigate these. Participants identified the need to establish prescribing impact, particularly around difficult to measure aspects such as more holistic conversations and enhanced practice directly attributed to prescribing knowledge. GPs were supportive of physiotherapists prescribing.
Establishment of physiotherapy independent prescribing value and impact is required to evaluate the role of, and requirement for, physiotherapy independent prescribers within primary care physiotherapy FCP roles. Additionally, there is a need for a review of physiotherapy prescribing permitted formulary, and development of support mechanisms for physiotherapists at individual and system levels to build prescribing self-efficacy and autonomy, and to advance and sustain physiotherapy independent prescribing in primary care.
从物理治疗师和全科医生的角度探讨肌肉骨骼（MSk）物理治疗在初级保健中的独立处方经验，并确定这些经验对初级保健中当代物理治疗实践的影响。
英国（UK）2013 年的立法改革使持有研究生非医疗处方资格的物理治疗师能够独立开处方某些有助于患者管理的药物。物理治疗师的独立处方是角色转变和目的的相对现代发展，与初级保健中物理治疗师第一接触从业者（FCP）角色的发展同时发生。
采用批判现实主义方法，通过对初级保健中 15 名物理治疗师和全科医生的 15 次半结构化访谈收集定性数据。应用主题分析。
共访谈了 15 名参与者（13 名物理治疗师，2 名全科医生）。在 13 名物理治疗师中，8 名是物理治疗独立处方者，3 名是 MSk 服务负责人，3 名是物理治疗顾问。参与者在 15 个地点和 12 个组织中工作。
尽管物理治疗师因独立处方资格而获得授权，但他们对英国现行的管制药物立法感到沮丧。物理治疗师报告了脆弱性、孤立感和风险是独立处方的潜在挑战，但指出临床经验和“患者里程”对于减轻这些挑战至关重要。参与者确定需要建立处方的影响，特别是在难以衡量的方面，如更全面的对话和直接归因于处方知识的增强实践。全科医生支持物理治疗师的处方。
需要建立物理治疗独立处方的价值和影响，以评估物理治疗独立从业者在初级保健中物理治疗师 FCP 角色中的作用和需求。此外，需要审查物理治疗允许的处方清单，并为个人和系统层面的物理治疗师制定支持机制，以建立处方自我效能和自主性，并推进和维持初级保健中的物理治疗独立处方。
