Objectives
Canadian pharmacists are utilizing different types of prescribing in their practice since 2007 which may increase the efficiency of the healthcare system. Characterizing the pharmacists based on their types of prescribing adoption may help policy makers and researchers to understand the adoption. The study objective was to describe the relationship between pharmacists, their prescribing practices, and support from the practice environment.
Methods
A cross sectional survey was tested for validity and reliability in three stages and administered from April to June in 2013 to a random sample of 700 practicing registered pharmacists in Alberta to explore adoption of pharmacist prescribing. We used descriptive analysis to measure the participants demographic information and cluster analysis to characterize and group the participants based on their prescribing behavior. Chi-square and ANOVA were used to compare the groups of pharmacists according to their practice setting and level of support from practice environment.
Results
Total response was 378 (54%) with majority of pharmacist involved in prescribing activities. We identified three types of pharmacist prescribers - renewal focused prescriber (74%), comprehensive adopter (9%), and disease focused prescriber (17%) who prescribed by employment of focused/higher level of clinical knowledge. Most of the renewal focused prescribers were from community pharmacy practice (84%) whereas 68% disease focused prescribers were from hospital/consultancy settings. Pharmacists experiences of support, for example, pharmacy staffing, access to patient information, patients and employers expectations from the practice environment were significantly different among three clusters [F(2,300)=4.071, p=0.018]. Increased level of support from practice environment facilitated comprehensive adoption of prescribing.
Conclusion
Pharmacist prescribing was adopted in three distinct ways: renewal focused, comprehensive, and disease focused prescribing. Future research on adoption of pharmacist prescribing should account for practice environment and related support.
