References

Abuzour AS, Lewis PJ, Tully MP Practice makes perfect: A systematic review of the expertise development of pharmacist and nurse independent prescribers in the United Kingdom. Res Social Adm Pharm.. 2018; 14:(1)6-17 https://doi.org/10.1016/j.sapharm.2017.02.002

Ajzen I The theory of planned behavior. Organ Behav Hum Decis Process.. 1991; 50:(2)179-211 https://doi.org/10.1016/0749-5978(91)90020-T

Bourne RS, Whiting P, Brown LS, Borthwick M Pharmacist independent prescribing in critical care: results of a national questionnaire to establish the 2014 UK position. Int J Pharm Pract.. 2016; 24:(2)104-113 https://doi.org/10.1111/ijpp.12219

Braun V, Clarke V Using thematic analysis in psychology. Qual Res Psychol.. 2006; 3:(2)77-101 https://doi.org/10.1191/1478088706qp063oa

Braun V, Clarke V To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual Res Sport Exerc Health.. 2021; 13:(2)201-216 https://doi.org/10.1080/2159676X.2019.1704846

Charrois T, Rosenthal M, Hoti K, Hughes C Pharmacy student perceptions of pharmacist prescribing: a comparison study. Pharmacy (Basel).. 2013; 1:(2)237-247 https://doi.org/10.3390/pharmacy1020237

Conner M, Norman P Predicting and changing health behaviour: research and practice with social cognition models. 2015;

Cope LC, Abuzour AS, Tully MP Nonmedical prescribing: where are we now?. Ther Adv Drug Saf. 2016; 7:(4)165-172

Courtenay M, Carey N, Stenner K Non medical prescribing leads views on their role and the implementation of non medical prescribing from a multi-organisational perspective. BMC Health Serv Res.. 2011; 11:(1) https://doi.org/10.1186/1472-6963-11-142

Courtenay M, Carey N, Stenner K An overiew of non medical prescribing across one strategic health authority: a questionnaire survey. BMC Health Serv Res.. 2012; 12:(1) https://doi.org/10.1186/1472-6963-12-138

Supplementary prescribing by nurses, pharmacists, chiropodists/podiatrists, physiotherapists and radiographers within the NHS in England: a guide for implementation. 2005;

Improving Patients’ Access to Medicines: A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the NHS in England. 2006;

Edwards J, Coward M, Carey N Barriers and facilitators to implementation of non-medical independent prescribing in primary care in the UK: a qualitative systematic review. BMJ Open.. 2022; 12:(6) https://doi.org/10.1136/bmjopen-2021-052227

Standards for the education and training of pharmacist independent prescribers. 2019;

New Standards for Initial Education and Training of Pharmacists Approved. 2020; https//www.pharmacyregulation.org/news/new-standards-initial-education-and-training-pharmacists-approved

Glenwick D, Jason L Handbook of Methodological Approaches to Community-Based Research: Qualitative, Quantitative, and Mixed Methods. 2016;

Haririan H, Rahmani A, Porter JE, Heidarzadeh M, Azadi A, Faghani S, Moradi N Nursing students’ attitude and preparedness for nurse prescribing and its relationship with self-efficacy. Nurse Educ Pract.. 2021; 54 https://doi.org/10.1016/j.nepr.2021.103126

Haririan H, Seresht DM, Hassankhani H, Porter JE, Wytenbroek L Nurses, physicians and patients’ knowledge and attitudes about nurse prescribing. BMC Nurs.. 2022; 21:(1) https://doi.org/10.1186/s12912-022-00888-0

Hindi AMK, Seston EM, Bell D, Steinke D, Willis S, Schafheutle EI Independent prescribing in primary care: A survey of patients’, prescribers’ and colleagues’ perceptions and experiences. Health Soc Care Community.. 2019; 27:(4)e459-e470 https://doi.org/10.1111/hsc.12746

Lewis PJ, Tully MP The discomfort of an evidence-based prescribing decision. J Eval Clin Pract.. 2009; 15:(6)1152-1158 https://doi.org/10.1111/j.1365-2753.2009.01250.x

Likic R, Maxwell SRJ Prevention of medication errors: teaching and training. Br J Clin Pharmacol.. 2009; 67:(6)656-661 https://doi.org/10.1111/j.1365-2125.2009.03423.x

Makowsky MJ, Guirguis LM, Hughes CA, Sadowski CA, Yuksel N Factors influencing pharmacists’ adoption of prescribing: qualitative application of the diffusion of innovations theory. Implement Sci.. 2013; 8:(1) https://doi.org/10.1186/1748-5908-8-109

Mills T, Patel N, Ryan K Pharmacist non‐medical prescribing in primary care. A systematic review of views, opinions, and attitudes. Int J Clin Pract.. 2021; 75:(3) https://doi.org/10.1111/ijcp.13827

Noblet T, Marriott J, Graham-Clarke E, Rushton A Barriers to and facilitators of independent non-medical prescribing in clinical practice: a mixed-methods systematic review. J Physiother.. 2017; 63:(4)221-234 https://doi.org/10.1016/j.jphys.2017.09.001

Ross JD, Kettles AM Mental health nurse independent prescribing: what are nurse prescribers’ views of the barriers to implementation?. J Psychiatr Ment Health Nurs. 2012; 19:(10)916-932 https://doi.org/10.1111/j.1365-2850.2011.01872.x

A Competency Framework for all Prescribers. 2016;

Schunk DH, DiBenedetto MK Motivation and social cognitive theory. Contemp Educ Psychol.. 2020; 60 https://doi.org/10.1016/j.cedpsych.2019.101832

Scrafton J, McKinnon J, Kane R Exploring nurses’ experiences of prescribing in secondary care: informing future education and practice. J Clin Nurs.. 2012; 21:(13-14)2044-2053 https://doi.org/10.1111/j.1365-2702.2011.04050.x

Stewart D, Jebara T, Cunningham S, Awaisu A, Pallivalapila A, MacLure K Future perspectives on nonmedical prescribing. Ther Adv Drug Saf.. 2017; 8:(6)183-197 https://doi.org/10.1177/2042098617693546

Taylor SJ, Bogdan R Introduction to Qualitative Research Methods: The Search for Meanings. 1984;

Tully MP, Ashcroft DM, Dornan T, Lewis PJ, Taylor D, Wass V The causes of and factors associated with prescribing errors in hospital inpatients: a systematic review. Drug Saf.. 2009; 32:(10)819-836 https://doi.org/10.2165/11316560-000000000-00000

Weglicki RS, Reynolds J, Rivers PH Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing. Nurse Educ Today.. 2015; 35:(1)227-231 https://doi.org/10.1016/j.nedt.2014.08.009

Wickware C Pharmacist independent prescriber workforce has more than tripled since 2016. 2021; https//pharmaceutical-journal.com/article/news/pharmacist-independent-prescriber-workforce-has-more-than-tripled-since-2016

Enablers and barriers to pharmacists and nurses becoming independent prescribers

02 January 2024
Volume 6 · Issue 1

Abstract

Independent prescribing was introduced in the UK in 2006, allowing qualified nurses and pharmacists to prescribe medicines independently; however, only 13% of nurses and 15% of pharmacists are currently independent prescribers (IPs). This study aimed to explore the factors that influence the intended behaviours of pharmacists and nurses enrolled on an independent prescribing course, and identifies enablers and barriers to becoming IPs. A cross-sectional qualitative study used semi-structured interviews based on two models of health behaviour: social cognitive theory and the theory of planned behaviour. A total of 20 interviews were completed with 15 pharmacists and five nurses. Themes that emerged related to attitudes, facilitators, barriers, social and environmental influences, and optimism. Participants demonstrated a positive attitude and a willingness to progress in their roles, but some participants stated that time constraints were the most significant barrier to becoming IPs. Consideration of the results of this study will reinforce the intention of these groups to become prescribers and engage in the role of enhancing healthcare outcomes.

In the UK, ‘non-medical prescriber’ (NMP) is an umbrella term that describes all health professionals, except physicians and dentists, who have completed a higher qualification in prescribing and are legally authorised to prescribe medications to patients (Cope et al, 2016). To commence their prescribing responsibilities, NMPs must complete an approved prescribing course and register with their relevant professional bodies (Noblet et al, 2017). Non-medical prescribing mainly comprises two models: supplementary non-medical prescribing (sNMP) and independent non-medical prescribing (iNMP).

Nurses and pharmacists were given supplementary prescribing rights in 2003, permitting them to prescribe medications under patient agreement (Department of Health and Social Care (DHSC), 2005). To proceed to successful supplementary prescribing, a voluntary partnership between the physician and the supplementary prescriber was fundamental to develop an agreed clinical management plan; then, the supplementary prescriber could prescribe medications from the agreed list without physician involvement (DHSC, 2005).

Register now to continue reading

Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month