J Am Pharm Assoc (2003). 2024 Nov-Dec;64(6):102192. doi: 10.1016/j.japh.2024.102192. Epub 2024 Jul 22.
Due to the shortage of professionals and the ever-increasing need for and demand for appointments, consultation with physicians is becoming increasingly difficult, and delays are increasing. To limit this issue, several countries have experimented with different models of independent prescribing through pharmacies.
This study aimed to analyze the contribution of independent prescribing by community pharmacists in primary care using a micro, meso, and macrolevel framework.
This was a scoping review of 3 different databases: Medline, Scopus, and Embase. The search (all databases) was executed on May 14, 2024. To be selected for the review, articles needed to be published after 2000, written in English or French, and focused on independent prescribing by community pharmacists. The articles had to investigate the pharmacist-independent prescribing (PIP) efficacy, effectiveness, or efficiency. Only original research was included. The bibliographies of the included papers were reviewed for additional studies. The articles were imported into Covidence to perform the review.
The search yielded 2802 articles, and 1062 remained after removing duplicates. Finally, 13 studies were included in the scoping review. As an independent prescriber, the community pharmacist can improve patient access to primary care, reducing treatment delays (microlevel). In addition, patient safety is maintained, and patients' quality of life is increased. Giving the community pharmacist an extra role helps reduce the workload on physicians, and thus facilitates access to care (mesolevel). The PIP model seems to be cost-effective for society and avoid medical consultations (macrolevel).
This review highlights the potential value and relevance of pharmacist-independent prescribers. Minor ailment services were frequently described, but PIP has also been implemented for chronic conditions. The benefits to society are felt at all levels: micro, meso, and macro. Its effectiveness and efficacy have been established, but additional studies are needed, particularly on its efficiency.
由于专业人员短缺，以及对预约的需求和需求不断增加，与医生的咨询变得越来越困难，且等待时间也在增加。为了限制这个问题，一些国家通过药店尝试了不同的独立处方模式。
本研究旨在使用微观、中观和宏观框架分析社区药剂师在初级保健中的独立处方的贡献。
这是对 3 个不同数据库（Medline、Scopus 和 Embase）的范围综述。搜索（所有数据库）于 2024 年 5 月 14 日执行。为了被纳入综述，文章必须在 2000 年后发表，用英文或法文书写，并且重点关注社区药剂师的独立处方。文章必须调查药剂师独立处方（PIP）的疗效、有效性或效率。仅包括原始研究。纳入论文的参考文献也用于查找其他研究。将文章导入 Covidence 进行综述。
搜索产生了 2802 篇文章，去除重复项后还剩 1062 篇。最终，13 项研究被纳入范围综述。作为独立处方者，社区药剂师可以改善患者获得初级保健的机会，减少治疗延迟（微观层面）。此外，还能维持患者的安全并提高其生活质量。赋予社区药剂师额外的角色有助于减轻医生的工作量，从而促进获得医疗服务（中观层面）。PIP 模式似乎对社会具有成本效益，可以避免医疗咨询（宏观层面）。
本综述强调了独立处方药剂师的潜在价值和相关性。经常描述小病服务，但也已为慢性病实施了 PIP。社会在微观、中观和宏观层面都感受到了其益处。它的有效性和功效已经得到证实，但还需要更多的研究，特别是其效率方面的研究。
