Pharmacists prescribers are pharmacists who have the authority to prescribe medications. The most well-established form is dependent prescribing, where a pharmacist prescribes drugs under the authority of a physician (e.g., collaborative care agreement). In Slovenia, there are already pharmacist consultants where pharmacists provide medication reviews but do not have prescribing rights. The results of such collaboration are positive, indicating the potential to upgrade the service to pharmacist prescribers.

Problem identification

Patients often have numerous medication-related problems, which diminish the overall quality of life. Additionally, access to health services is a significant issue (e.g., shortage of family physicians). One solution to mitigate medication-related problems and improve access to health services is to include pharmacist prescribers in ambulatory clinics.  

Review of research in this area

Research shows that pharmacist prescribers contribute to better clinical outcomes and alleviate the burden on doctors, increasing access to health services. This collaboration is also strongly associated with the discontinuation of unnecessary medication and polypharmacy reduction. Researchers have reported positive effects of this cooperation on the work of family doctors (workload is reduced). There is practically no data on this topic in this part of Europe. Such data is essential for planning appropriate development strategies at the primary care level and beyond.

Objectives

The project examines the feasibility of pharmacists’ dependent prescribing within the Slovenian health system through pharmacist consultant clinics. The project aims to identify the benefits, challenges, and systemic changes required to implement this type of cooperation. The main goals are: 1) to assess the possibility of upgrading the current collaboration to include dependent prescribing in pharmacist consultant clinics (treatment outcomes for predefined disease states), 2) to collect and analyze data to determine the feasibility of dependent prescribing in pharmacist consultant clinics 3) to prepare cooperation protocols and establish a method for dependent prescribing (collaborative care agreement plan) 4) to identify the necessary systemic and legislative changes required to implement this new pharmaceutical competence 5) to determine quality indicators for this type of cooperation. We hypothesize that interventions by pharmacist prescribers will lead to better treatment outcomes.

Working programme

The project group will consist of pharmacists and family physicians. First, we will coordinate the Ethics Commission application and prepare the collaborative care agreement document. After approval, we will create protocols for dependent prescribing for predetermined conditions and present the pilot project in individual primary care centres. We will implement a six-month pilot project as a prospective clinical case study in four primary care centres in Slovenia. Pharmacist consultant clinics are already established in these centres. The pharmacist consultants will prescribe the medication during the pharmacotherapy examination and monitor the treatment’s progress until the pilot project’s end. This will be followed by an analysis and publication of the results, along with proposals for systemic changes in Slovenia. The group consists of recognized clinical pharmacy and family medicine researchers with publications and clinical experience who have conducted pilot projects (e.g., pharmacist consultant in Pomurje).

Impact of the project

Our proposed research will be the first to follow up on pharmacist prescriber interventions in this part of Europe, serving as an upgrade to existing pharmacist consultant clinics in Slovenia. This will enable us to significantly enhance national accessibility to health services in Slovenia and contribute valuable new data for evaluating new health programs in Slovenia.