A study of the development of frameworks of pharmacist prescribing in Qatar.
Moza Al Hail
Several countries across the world have developed and implemented frameworks of non-medical prescribing. In the United Kingdom, pharmacist prescribing was introduced in 2003 as supplementary prescribing, with this extended to include independent prescribing in 2006. Pharmacist prescribing has been proven to be safe, clinically appropriate, and highly regarded by patients and other members of the healthcare team. In Qatar, pharmacy practice is rapidly evolving in an attempt to better utilise pharmacists' skills and thus improve patient health outcomes. Qatar National Vision 2030 aims to establish "a comprehensive world-class healthcare system whose services are accessible to the whole population". To facilitate achievement of this goal, there is potential for the development and implementation of frameworks of pharmacist prescribing in Qatar. The overall aim of this doctoral research was to explore the development of pharmacist prescribing frameworks in Qatar. A multi-modal research design was implemented across four phases with the findings of each phase informing the next. The first phase was an umbrella review of published systematic reviews on non-medical prescribing. Seven systematic reviews reported aspects of prescribing decision-making, processes of prescribing, barriers, and facilitators to implementation. Three of the reviews explored patient outcomes that were noted to be equivalent to or better than physician prescribing. Given the absence of systematic reviews of views and experiences of key stakeholders, the second phase was a systematic review of 65 studies to address this gap in knowledge. The majority of studies pre- and post-implementation reported positive findings. One key limitation of the studies was the general lack of any consideration for theories of implementation in study design, execution, and reporting. The third phase was grounded in the Consolidated Framework of Implementation Research, involving semi-structured qualitative interviews with key stakeholders in positions of power and influence in Qatar. Data saturation was achieved on completion of 37 interviews, the findings of which highlighted support for the development and implementation of pharmacist prescribing in Qatar, with many potential benefits described. Findings of all three phases were incorporated into a final phase Delphi study aiming to determine the levels of agreement amongst key stakeholders in Qatar around the development of pharmacist prescribing frameworks. The scope of the developed framework included: definitions, models and scope of prescribing; education and training; prescribing practice and governance. High levels of agreement were achieved for Delphi statements relating to the Collaborative Pharmacist Prescribing model, thus indicating it as being the most appropriate for Qatar. In conclusion, this research has provided original, robust and rigorous findings which can support implementation of frameworks of pharmacist prescribing in Qatar and beyond. Further research-based developmental work is required to translate this framework into an approved education and training course and practice.
This research programme was carried out in collaboration with Qatar University and the Hamad Medical Corporation, Qatar.
|Institution Citation||JEBARA, T. 2019. A study of the development of frameworks of pharmacist prescribing in Qatar. Robert Gordon University [online], PhD thesis. Available from: https://openair.rgu.ac.uk|
|Keywords||Pharmacists; Prescriptions; Professional health services; Prescribing behaviours; Qatar|
JEBARA 2019 A study of the development
Copyright: the author and Robert Gordon University