Skip to main content
Top
Published in: International Journal of Clinical Pharmacy 5/2021

01-10-2021 | Commentary

Advanced pharmacist practice: where is the United Kingdom in pursuit of this ‘Brave New World’?

Authors: Paul Forsyth, Gordon F. Rushworth

Published in: International Journal of Clinical Pharmacy | Issue 5/2021

Login to get access

Abstract

Pharmacy has developed many novel patient-facing roles across the globe, typically delivered through the lens of pharmaceutical care. The macro-level implementation of such interventions is, however, fraught with difficulty. At an individual-level, psychological barriers of pharmacists and their ability to deliver autonomous complex clinical care are key considerations. As the United Kingdom imminently plans to launch a new advanced pharmacist practice curriculum and credentialing process to support advanced skills development, this commentary discusses where progress to date has taken us and what other developmental, environmental and cultural changes are needed to support this. The commentary also challenges some of pharmacy’s historic dogma, discusses a requirement for teaching to transcend simplistic concepts of medicines-harm, considers the need for the standardisation of clinical skills and discusses the necessity of formal advanced practice programmes and preceptorship models. It finally proposes the concept of Advanced Pharmacist Practitioners as the ultimate future vision of autonomous practice and the need for Government Policy to support their creation.
Literature
1.
go back to reference Bates I, Bader LR, Galbraith K. A global survey on trends in advanced practice and specialisation in the pharmacy workforce. Int J Pharm Pract. 2020;28:173–81.CrossRef Bates I, Bader LR, Galbraith K. A global survey on trends in advanced practice and specialisation in the pharmacy workforce. Int J Pharm Pract. 2020;28:173–81.CrossRef
2.
go back to reference Bader LR, Bates I, Galbraith K. Trends in advanced practice and specialisation in the global pharmacy workforce: a synthesis of country case studies. Int J Pharm Pract. 2020;28:182–90.CrossRef Bader LR, Bates I, Galbraith K. Trends in advanced practice and specialisation in the global pharmacy workforce: a synthesis of country case studies. Int J Pharm Pract. 2020;28:182–90.CrossRef
5.
go back to reference Hazen ACM, de Bont AA, Boelman L, Zwart DLM, de Gier JJ, de Wit NJ, et al. The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: a systematic review. Res Soc Adm Pharmacy. 2018;14:228–40.CrossRef Hazen ACM, de Bont AA, Boelman L, Zwart DLM, de Gier JJ, de Wit NJ, et al. The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: a systematic review. Res Soc Adm Pharmacy. 2018;14:228–40.CrossRef
6.
go back to reference Weeks G, George J, Maclure K, Stewart D. Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Database Syst Rev. 2016;11:CD011227.PubMed Weeks G, George J, Maclure K, Stewart D. Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Database Syst Rev. 2016;11:CD011227.PubMed
7.
go back to reference Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.PubMed Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.PubMed
8.
go back to reference Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008;168:687–94.CrossRef Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008;168:687–94.CrossRef
9.
go back to reference Pousinho S, Morgado M, Falcão A, Alves G. Pharmacist interventions in the management of type 2 diabetes mellitus: a systematic review of randomized controlled trials. J Manag Care Spec Pharm. 2016;22:493–515.PubMed Pousinho S, Morgado M, Falcão A, Alves G. Pharmacist interventions in the management of type 2 diabetes mellitus: a systematic review of randomized controlled trials. J Manag Care Spec Pharm. 2016;22:493–515.PubMed
10.
go back to reference Evans C, Pearce R, Greaves S, Blake H. Advanced clinical practitioners in primary care in the UK: a qualitative study of workforce transformation. Int J Environ Res Public Health. 2020;17:4500.CrossRef Evans C, Pearce R, Greaves S, Blake H. Advanced clinical practitioners in primary care in the UK: a qualitative study of workforce transformation. Int J Environ Res Public Health. 2020;17:4500.CrossRef
12.
go back to reference The Scottish Government. Achieving excellence in pharmaceutical care: a strategy for Scotland. Edinburgh: Scottish Government; 2017. The Scottish Government. Achieving excellence in pharmaceutical care: a strategy for Scotland. Edinburgh: Scottish Government; 2017.
13.
go back to reference Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change? Can Pharm J. 2010;143:37–42.CrossRef Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change? Can Pharm J. 2010;143:37–42.CrossRef
14.
go back to reference Fisher J, Kinnear M, Reid F, Souter C, Stewart D. What supports hospital pharmacist prescribing in Scotland? A mixed methods, exploratory sequential study. Res Soc Adm Pharm. 2018;14:488–97.CrossRef Fisher J, Kinnear M, Reid F, Souter C, Stewart D. What supports hospital pharmacist prescribing in Scotland? A mixed methods, exploratory sequential study. Res Soc Adm Pharm. 2018;14:488–97.CrossRef
15.
go back to reference Zhou M, Desborough J, Parkinson A, Douglas K, McDonald D, Boom K. Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences. Int J Pharm Pract. 2019;27:479–89.CrossRef Zhou M, Desborough J, Parkinson A, Douglas K, McDonald D, Boom K. Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences. Int J Pharm Pract. 2019;27:479–89.CrossRef
16.
go back to reference Rosenthal M, Austin Z, Farrell J, Tsuyuki RT. Overcoming our nature and nurture. Can Pharm J. 2017;150:5–7.CrossRef Rosenthal M, Austin Z, Farrell J, Tsuyuki RT. Overcoming our nature and nurture. Can Pharm J. 2017;150:5–7.CrossRef
17.
go back to reference Maddox C, Halsall D, Hall J, Tully MP. Factors influencing nurse and pharmacist willingness to take or not take responsibility for non-medical prescribing. Res Soc Adm Pharm. 2016;12:41–55.CrossRef Maddox C, Halsall D, Hall J, Tully MP. Factors influencing nurse and pharmacist willingness to take or not take responsibility for non-medical prescribing. Res Soc Adm Pharm. 2016;12:41–55.CrossRef
19.
go back to reference Brazinha I, Fernandez-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. Int J Clin Pharm. 2014;36:1031–8.CrossRef Brazinha I, Fernandez-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. Int J Clin Pharm. 2014;36:1031–8.CrossRef
20.
go back to reference Frankel GEC, Austin Z. Responsibility and confidence: identifying barriers to advanced pharmacy practice. Can Pharm J 2013;146:155–61.CrossRef Frankel GEC, Austin Z. Responsibility and confidence: identifying barriers to advanced pharmacy practice. Can Pharm J 2013;146:155–61.CrossRef
21.
go back to reference Auta A, Strickland-Hodge B, Maz J. Challenges to clinical pharmacy practice in Nigerian hospitals: a qualitative exploration of stakeholders’ views. J Eval Clin Pract. 2016;22:155–61.CrossRef Auta A, Strickland-Hodge B, Maz J. Challenges to clinical pharmacy practice in Nigerian hospitals: a qualitative exploration of stakeholders’ views. J Eval Clin Pract. 2016;22:155–61.CrossRef
22.
go back to reference McIntosh T, Stewart D. A qualitative study of UK pharmacy pre-registration graduates’ view and reflections on pharmacist prescribing. Int J Pharm Pract. 2016;24:139–41.CrossRef McIntosh T, Stewart D. A qualitative study of UK pharmacy pre-registration graduates’ view and reflections on pharmacist prescribing. Int J Pharm Pract. 2016;24:139–41.CrossRef
23.
go back to reference Scottish Government Polypharmacy Model of Care Group. Polypharmacy guidance, realistic prescribing. 3rd ed. Edinburgh: Scottish Government; 2018. Scottish Government Polypharmacy Model of Care Group. Polypharmacy guidance, realistic prescribing. 3rd ed. Edinburgh: Scottish Government; 2018.
26.
go back to reference Hepler CD. Clinical pharmacy, pharmaceutical care, and the quality of drug therapy. Pharmacotherapy. 2004;24:1491–8.CrossRef Hepler CD. Clinical pharmacy, pharmaceutical care, and the quality of drug therapy. Pharmacotherapy. 2004;24:1491–8.CrossRef
27.
go back to reference Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121–34.CrossRef Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121–34.CrossRef
31.
go back to reference Fuller KA, Donahue B, Kruse A. Examining student self-awareness of performance on entrustable professional activities given context of preceptor evaluations. J Am Coll Clin Pharm. 2021;4:169–75. Fuller KA, Donahue B, Kruse A. Examining student self-awareness of performance on entrustable professional activities given context of preceptor evaluations. J Am Coll Clin Pharm. 2021;4:169–75.
Metadata
Title
Advanced pharmacist practice: where is the United Kingdom in pursuit of this ‘Brave New World’?
Authors
Paul Forsyth
Gordon F. Rushworth
Publication date
01-10-2021
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy / Issue 5/2021
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-021-01276-5

Other articles of this Issue 5/2021

International Journal of Clinical Pharmacy 5/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine