Taryn Heck1, Mary Gunther2, Lauren Bresee1, Tania Mysak1, Chloe Mcmillan1, Sheri Koshman1. 1. Taryn Heck, B.Sc.Pharm., ACPR, is Clinical Pharmacist, University of Alberta Hospital, Edmonton, Canada. Mary Gunther, B.Sc. Pharm., ACPR, is Clinical Practice Leader-Pediatric Critical Care, Alberta Health Services (AHS), Edmonton. Lauren Bresee, B.Sc. Pharm., M.Sc., Ph.D., ACPR, is Drug Stewardship Pharmacist-Calgary Zone, AHS, and Adjunct Assistant Professor, Department of Community Health Sciences, University of Calgary, Calgary, Canada. Tania Mysak, B.S.P., Pharm.D., is Director of Practice, Pharmacy Services, AHS, Edmonton. Chloe Mcmillan, B.Sc.Pharm., is Clinical Pharmacist, University of Alberta Hospital. Sheri Koshman, B.Sc.Pharm., Pharm.D., ACPR, is Associate Professor of Medicine, Division of Cardiology, Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton. 2. Taryn Heck, B.Sc.Pharm., ACPR, is Clinical Pharmacist, University of Alberta Hospital, Edmonton, Canada. Mary Gunther, B.Sc. Pharm., ACPR, is Clinical Practice Leader-Pediatric Critical Care, Alberta Health Services (AHS), Edmonton. Lauren Bresee, B.Sc. Pharm., M.Sc., Ph.D., ACPR, is Drug Stewardship Pharmacist-Calgary Zone, AHS, and Adjunct Assistant Professor, Department of Community Health Sciences, University of Calgary, Calgary, Canada. Tania Mysak, B.S.P., Pharm.D., is Director of Practice, Pharmacy Services, AHS, Edmonton. Chloe Mcmillan, B.Sc.Pharm., is Clinical Pharmacist, University of Alberta Hospital. Sheri Koshman, B.Sc.Pharm., Pharm.D., ACPR, is Associate Professor of Medicine, Division of Cardiology, Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton. mary.gunther@ahs.ca.
Abstract
PURPOSE: Results of a survey to determine the frequency of prescribing by Canadian hospital pharmacists with independent prescribing authority are reported. METHODS: A Web-based questionnaire was used to collect data on the prescribing activities of a designated group of hospital-affiliated pharmacists in the province of Alberta who had been granted "additional prescribing authorization" (APA) through a peer-review process and were providing clinical pharmacy services in inpatient and/or outpatient settings at the time of the survey (January-March 2014). Descriptive statistics and logistic regression analysis were used to determine the median weekly frequency of prescribing, factors associated with increased use of APA, and perceived prescribing barriers and enablers. RESULTS: The survey response rate was about 50% (77 of 153 eligible pharmacists). The median self-reported number of prescriptions and medication orders written during an average week was 4.2 (interquartile range, 2.0-10.0) per 10 patients. Antibiotics and anticoagulants were the most commonly prescribed medications. Interdisciplinary care team dynamics was rated as a leading enabler of prescribing but also a leading barrier to the exercise of APA. The greatest motivators to apply for APA were the potential for increased efficiency and the potential for enhanced patient care. CONCLUSION: The survey results indicated that, in an average week, hospital pharmacists with APA prescribed for almost half of the patients they cared for as part of the interdisciplinary team. Prescribing most frequently occurred after team discussion and most often involved adjusting dosages based on organ function and clinical assessment.
PURPOSE: Results of a survey to determine the frequency of prescribing by Canadian hospital pharmacists with independent prescribing authority are reported. METHODS: A Web-based questionnaire was used to collect data on the prescribing activities of a designated group of hospital-affiliated pharmacists in the province of Alberta who had been granted "additional prescribing authorization" (APA) through a peer-review process and were providing clinical pharmacy services in inpatient and/or outpatient settings at the time of the survey (January-March 2014). Descriptive statistics and logistic regression analysis were used to determine the median weekly frequency of prescribing, factors associated with increased use of APA, and perceived prescribing barriers and enablers. RESULTS: The survey response rate was about 50% (77 of 153 eligible pharmacists). The median self-reported number of prescriptions and medication orders written during an average week was 4.2 (interquartile range, 2.0-10.0) per 10 patients. Antibiotics and anticoagulants were the most commonly prescribed medications. Interdisciplinary care team dynamics was rated as a leading enabler of prescribing but also a leading barrier to the exercise of APA. The greatest motivators to apply for APA were the potential for increased efficiency and the potential for enhanced patient care. CONCLUSION: The survey results indicated that, in an average week, hospital pharmacists with APA prescribed for almost half of the patients they cared for as part of the interdisciplinary team. Prescribing most frequently occurred after team discussion and most often involved adjusting dosages based on organ function and clinical assessment.