Characteristics of prescribing activity within primary care in Scotland 2013–2022 of general practitioners, nurse, pharmacist and allied health prescribers: A retrospective cross-sectional study

MacVicar, Sonya; Paterson, Ruth E.

Abstract

Background
Independent prescribing by nurses, pharmacists and allied health professionals is diversifying into a variety of healthcare settings as pressures mount on existing resources. Primary care was an early adopter of prescribing by non-medical professionals with resulting improvements in accessibility and flexibility of services but also noted barriers. Exploring existing prescribing activity within primary care can support future initiatives that are cognisant of the needs of this specific population and targeted in the use of finite resources.

Aim
To explore the characteristics of prescribing activity of common drugs dispensed by community pharmacies in Scotland by prescribing groups of general practitioners, nurses, pharmacist and allied health professionals. Specifically, to compare overall drug prescribing frequency by prescriber group and identify emergent prescribing patterns of individual drugs.

Design
A cross-sectional study.

Methods
The data from Public Health Scotland on frequency of the ten most common drugs prescribed and dispensed from community pharmacies between 2013 and 2022 by prescriber group were examined, applying descriptive statistics using secondary data analysis.

Results
Prescribing activity in non-medical prescribing groups accounted for 2%–3% of overall prescribing activity in primary care. There is a growing interprofessional approach to prescribing in chronic disease. Proton pump inhibitors were the most commonly prescribed medication overall with a 4-fold increase in nurse prescribing. The decline in prescribing frequency caused by COVID 19 restrictions has since returned to pre-pandemic levels.

Conclusion
There is a growing contribution of nurse independent prescriber activity within primary care although still a relatively small proportion compared to medical practitioners. The pattern of increased prescribing of medications for long term and chronic conditions such as proton pump inhibitors by all prescribers is suggestive of multi-disciplinary professionals supporting increased patient demand. This study provides a baseline to evaluate current service provision in further research and enable professional, service and policy development.

Citation

MacVicar, S., & Paterson, R. E. (2023). Characteristics of prescribing activity within primary care in Scotland 2013–2022 of general practitioners, nurse, pharmacist and allied health prescribers: A retrospective cross-sectional study. Journal of Advanced Nursing, 79(8), 3092-3101. https://doi.org/10.1111/jan.15658

• Journal Article Type: Article
• Acceptance Date: Mar 15, 2023
• Online Publication Date: Mar 27, 2023
• Publication Date: 2023-08
• Deposit Date: Mar 30, 2023
• Publicly Available Date: Mar 30, 2023
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 79
• Issue: 8
• Pages: 3092-3101
• DOI: https://doi.org/10.1111/jan.15658
• Keywords: analgesia, cross-sectional, non-medical prescribing, nurse, nurse independent prescriber, omeprazole, pharmacist prescriber, primary care, Scotland