Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK.
BMJ Open. 2023 May 2;13(5):e067907. doi: 10.1136/bmjopen-2022-067907.
Non-medical prescribing (NMP) is a key feature of the UK healthcare system that refers to the legal prescribing rights granted to nurses, pharmacists and other non-medical healthcare professionals who have completed an approved training programme. NMP is deemed to facilitate better patient care and timely access to medicine. The aim of this scoping review is to identify, synthesise and report the evidence on the costs, consequences and value for money of NMP provided by non-medical healthcare professionals.
Scoping review DATA SOURCES: MEDLINE, Cochrane Library, Scopus, PubMed, ISI Web of Science and Google Scholar were systematically searched from 1999 to 2021.
Peer-reviewed and grey literature written in English were included. The research was limited to original studies evaluating economic values only or both consequences and costs of NMP.
The identified studies were screened independently by two reviewers for final inclusion. The results were reported in tabular form and descriptively.
A total of 420 records were identified. Of these, nine studies evaluating and comparing NMP with patient group discussions, general practitioner-led usual care or services provided by non-prescribing colleagues were included. All studies evaluated the costs and economic values of prescribing services by non-medical prescribers, and eight assessed patient, health or clinical outcomes. Three studies showed pharmacist prescribing was superior in all outcomes and cost saving at a large scale. Others reported similar results in most health and patient outcomes across other non-medical prescribers and control groups. NMP was deemed resource intensive for both providers and other groups of non-medical prescribers (eg, nurses, physiotherapists, podiatrists).
The review demonstrated the need for quality evidence from more rigorous methodological studies examining all relevant costs and consequences to show value for money in NMP and inform the commissioning of NMP for different groups of healthcare professionals.
非医疗处方（NMP）是英国医疗保健系统的一个重要特征，指的是已完成经批准的培训计划的护士、药剂师和其他非医疗保健专业人员被授予的合法处方权。NMP 被认为可以促进更好的患者护理和及时获得药物。本范围综述的目的是确定、综合和报告非医疗保健专业人员提供的 NMP 的成本、后果和性价比的证据。
范围综述
从 1999 年到 2021 年，系统地在 MEDLINE、Cochrane 图书馆、Scopus、PubMed、ISI Web of Science 和 Google Scholar 上进行了搜索。
包括同行评议和英文撰写的灰色文献。研究仅限于仅评估经济价值或 NMP 的后果和成本的原始研究。
两名评审员独立筛选确定的研究以进行最终纳入。结果以表格形式和描述性方式报告。
共确定了 420 条记录。其中，纳入了九项研究，这些研究评估和比较了 NMP 与患者小组讨论、由全科医生主导的常规护理或由非处方同事提供的服务。所有研究都评估了非医疗处方者提供的处方服务的成本和经济价值，八项研究评估了患者、健康或临床结果。三项研究表明，在所有结果和大规模成本节约方面，药剂师处方都具有优势。其他研究报告了在大多数健康和患者结果方面，其他非医疗处方者和对照组的结果相似。NMP 被认为对提供者和其他非医疗处方者群体（例如护士、物理治疗师、足病医生）来说都是资源密集型的。
该综述表明，需要从更严格的方法学研究中获得高质量证据，以检查所有相关成本和后果，以证明 NMP 的性价比，并为不同群体的医疗保健专业人员提供 NMP 的委托。
