The benefits of prescribing authority for pharmacists

Share your thoughts: Scroll down to post a commentWhen I first obtained advanced prescribing authorization in 2009, two years after I started working as a pharmacist for a primary care network (PCN) in Alberta, I used to have a lot of conversations that went something like this: "So, are you a nurse or a doctor?""Actually, I’m neither. I am a pharmacist.""I've never heard of pharmacists working in medical clinics. Is this something new?" "Yes, it is fairly new.""And the prescription you just gave me for warfarin and the other injection—I didn't know pharmacists could write prescriptions. Is this new, too?""Yes, it is fairly new.""So, I don't have to see my doctor today?""No, not today. But Dr. B does want to follow up with you in one week to check your leg clot. There are a few other things I'd like to go over with you now as well, unless you have any more questions first?"I still have these conversations, but not as often—which is a small thrill for me, as it's another indication that I've become an integral part of a patient-focused interprofessional team.The collaboration comes in many forms, be it a quick hallway consult with the physician, a collaborative patient assessment with the nurse or one-on-one anticoagulation teaching with the patient. Diabetes management, smoking cessation and hypertension monitoring are a few other areas where we focus on using a team approach.Advanced prescribing authorization enabled me to further expand my role on our interprofessional team. For example, our PCN recently initiated a centralized anticoagulation program. Physicians refer patients who are starting on warfarin, require periprocedural management or who have unstable INRs and require teaching and more frequent monitoring. Once referred to the program, our pharmacists provide patient education, manage the patient's anticoagulation and prescribe warfarin, low molecular weight heparin and vitamin K, as needed. The ability to prescribe these medications provides complete care for the patient and eliminates the previous delays associated with prescription approvals—saving time for both patients and physicians.We've found that patients are pleased with the easy access to the pharmacists, who frequently help to communicate their other concerns to the physician as well. The team approach is a win-win for everyone involved.Dr. James Bell is a family doctor and physician lead for our PCN. I asked him to describe the benefits of an interprofessional healthcare team in his own words:"Our experience with interprofessional practice has been a huge success as far as I am concerned. This is exemplified by the anticoagulation program. Prior to the institution of this program we were frustrated with trying to deal with the large number of patients and the complexity involved when there was a problem or when there was need to interrupt the therapy for some reason or other. There was always a sense that time constraints interfered with giving patients adequate education to help keep them out of trouble, particularly in the patients just starting out on anticoagulation.“The anticoagulation program has allowed us to work closely with our pharmacists and this has led to a number of positive outcomes. There are fewer disruptions in my day, as the pharmacist is there to help deal with some of the more urgent problems. Patients are now better educated and prepared for anticoagulation, resulting in fewer problems with their control. As well, we are now able to provide better practice by bridging patients more appropriately.“Pharmacists' ability to prescribe has saved us time and effort. As well, I think both the physicians and the pharmacists have improved their knowledge base by feeding off each other’s skill sets. The positive experience in the area of anticoagulation has helped us develop trusting relationships with each other, which is now allowing us to move forward in a truly collaborative fashion with the care of many of our other patients with chronic disease."I couldn't agree more with Dr. Bell. The anticoagulation program is just the beginning for our team, and our patients. We have built strong working relationships and have a clearer understanding of each other's clinical skills—which is spontaneously fostering collaboration in other areas of patient care. When you start working together, you have to strive for the little successes and build on them in order to move forward.Change may be difficult at first, but it gets easier as you see what can be achieved. Change then becomes not only easy, but exciting!Melissa Dechaine and Dr. James Bell are part of the St. Albert and Sturgeon Primary Care Network in Alberta, providing co-ordinated multidisciplinary primary care to more than 73,000 patients in St. Albert and Sturgeon County. Members of the network include pharmacists, nurses, dietitians, mental health co-ordinators and lactation consultants.

The benefits of prescribing authority for pharmacists

Register for free access or login.

More Blog Posts in This Series

How to establish the pharmacist's role in a collaborative practice

Collaboration on the go

Prescription adaptations by pharmacists are a better use of everyone's time, says B.C. physician

Blog Author

null null

Related Topics