Identifying and evaluating strategies for pharmacists to promote evidence-based prescribing in general practice
: (Alternative Format Thesis)

  • Mary Carter

Student thesis: Doctoral ThesisPhD

Abstract

Pharmacists are increasingly important members of UK general practice teams and have the potential to capitalise on their professional expertise and knowledge of medicines to improve prescribing in these settings. Details of how and the extent to which pharmacists influence prescribing general practice are not well-known,

This PhD aimed to identify the ways in which pharmacists are contributing to effective strategies which promote the evidence-based use of medicines in UK general practice.

The mixed methods used in this thesis included a qualitative exploration of the influences on prescribing in general practice, and of experiences and perceptions about pharmacists’ roles and potential as members of general practice teams. This investigation was complemented by a systematic review of the effectiveness of pharmacists’ interventions to improve evidence-based prescribing in primary care settings and a cross-sectional assessment of the ways in which pharmacists currently influence prescribing in UK general practice, the tools they use to do this and their associated attitudes and beliefs.

General practice prescribing is impacted by a range of intersecting factors operating at individual, practice and societal levels. General practice clinicians have mixed views about the current role and potential of practice-based pharmacists to increase evidence-based prescribing. Audit and Feedback (A&F) interventions involving pharmacists in varied primary healthcare systems are effective in encouraging prescribing that is aligned with the available evidence. Among a range of responsibilities in UK general practice, pharmacists are involved in many activities and services which influence prescribing. One such activity is conducting prescribing audits. While many practice pharmacists are engaged in prescribing audits, only a small proportion identify this work as A&F, despite substantial evidence of its effectiveness.

General practice-based pharmacists have the opportunity and potential to promote prescribing that is more closely aligned with evidence. By engaging in these influencing activities, they are helping to reduce inappropriate and inequitable prescribing. Gaining proficiency and confidence in using evidence-based tools for influencing will equip practice-based pharmacists to make an effective contribution to medicines use as valued members of multi-disciplinary general practice teams.
Date of Award2 Nov 2022
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorSarah Chapman (Supervisor) & Philip Rogers (Supervisor)

Keywords

  • pharmacists
  • prescribing
  • General practice
  • Evidence based practice

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