Views and perceptions on the designated prescribing practitioner role, barriers, and facilitators for its implementation in community pharmacy: a theory-based quantitative study
Authors: Jebara T , McIntosh T , Stewart F , Bruce R , Osprey A , Cunningham S 
Published: April 2022

Abstract

Introduction
Scottish Government aims to increase numbers of pharmacist independent prescribers (IP) in community to improve healthcare access. This includes utilising qualified IPs as Designated Prescribing Practitioners (DPP) to increase capacity to supervise pharmacists on IP courses.

Aim
To investigate views and perceptions of practice-based stakeholders and identify potential influences on DPP implementation for Scottish community pharmacists (CP)

Methods
A theory-based cross-sectional online survey of stakeholders involved in DPP role implementation (e.g. Directors of Pharmacy, Prescribing Leads, IP qualified CPs) was employed. Participation invites were shared with Scottish health boards and CP organisations via email and social media. Snowball sampling was used so no key individual was omitted. The questionnaire was informed by Royal Pharmaceutical Society (RPS) DPP Framework (1) and Consolidated Framework for Implementation Research (2). It examined views and awareness of DPP role, implementation drivers, and obstacles. The tool was reviewed for credibility and dependability then piloted. Data were analysed descriptively.

Results
Ninety-nine responses were received (NB: Since this was a national survey of multiple stakeholders without a defined sample list, response rate was indeterminate). Two-fifths (n=39, 40.2%) were community pharmacists with majority qualified for more than 10 years (n=76, 76.8%). Only 18 had previous involvement with IP courses. The table shows awareness and views of the role based on RPS framework. Respondents had positive attitudes to DPP implementation with the majority supporting it (72, 73.5%) and believing that its advantages outweigh any disadvantages (74, 75.5%). Facilitators of successful implementation were having clearly defined leadership roles (89, 90.9%), piloting (85, 87.6%), and incentives (65, 88.8%). Drivers for uptake of role included improving patient care (94, 96%) and the profession (91, 92.8%), self-development (91, 92.8%), developing individual pharmacists (89, 90.8%), payment (77, 79.4%), and being recognised by peers/employers (73, 75.2%).

Conclusion
There was positivity regarding DPP role, its acceptability in, and advantages for CP. Resource-related concerns were expressed that need further consideration to ensure effective implementation. This is the first study internationally to explore views on DPP role. Given the Scottish focus, findings may lack generalisability. Future research should focus on theory-based evaluation of structures and processes of implementation.

References
(1) Royal Pharmaceutical Society. Designated Prescribing Practitioner Competency Framework [internet]. London: Royal Pharmaceutical Society; 2019 [Cited 28/09/2021]. Available from: https://www.rpharms.com/resources/frameworks/designated-prescribing-practitioner-competency-framework
(2) Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.