I have studied my bachelors in India where almost all the changing times only doctors get excited about prescribing medicines. The concept of non-medical prescribing where other health professionals are actively involved with prescribing medications to patients was completely new if you ask me. With my knowledge of the services provided with in community pharmacies like OTC medication advice, PGD's, trivial ailments scheme, disaster and urgent supply, I came to the realization that community pharmacists positively participate in patient care and attention by writing prescriptions in case there is PGD's in Scotland. However, this isn't prescribing. I had formed to study a whole lot regarding this issue to get an idea of how non medical prescribing works, its background and advantages. The lectures of the prescribing knowledge component helped me a good deal in understanding supplementary and unbiased prescribing. I've studied a booklet on non-medical prescribing which offered me an perception into non-medical prescribing. I have learnt that non -medical prescribing in this country started in 1986 when nurses were advised to attempt prescribing. In 1994 nurses were permitted to prescribe from a limited formulary. It was in 2003 when supplementary prescribing for nurses and pharmacists started out. From May 2006 self-employed prescribing was created and expanded prescribing forces were in place for nurses and pharmacists. Nurse self-employed prescribers can recommend any licensed medication for any medical condition with in their part of competence which also contains some handled drugs. Pharmacist unbiased prescriber can prescribe any drug for just about any indicator with in their area of competence, but, this does not include handled drugs. I've also learnt that a supplementary prescribing differs from indie prescribing. In supplementary prescribing the supplementary prescriber voluntarily works together with an independent prescriber to apply a patient specific professional medical management plan. There is a significant participation of the patient in case of supplementary prescribing.
The benefits associated with non medical prescribing are 1) It increases patient treatment without compromising patient's basic safety 2) helps it be easier for patients to obtain the medicines they need 3) heightens patients choice in accessing drugs 4) makes better use of the skills of health professionals 5) donate to the introduction of more adaptable team working over the NHS. (pdf from 5 boroughs)
Furthermore, I've learned that competencies which can be set by Country wide Prescribing Centre for non-medical prescribers have to be achieved by the prescribers for effective and safe prescribing. The competency frame work developed can be utilized as an aid for training and development and also to assist individual CPD of the prescribers. You will find three regions of competency 1) The discussion 2) Prescribing effectively 2) Prescribing in context. Each of these regions of has three competencies. Consultation has three different competencies which are clinical and pharmaceutical knowledge, establishing options and communicating with patients. (Competencies)
My understanding of consultation was quite definitely confined to patient consultations between a pharmacist and patient during a medication utilization review. I had been exposed to such relationships with patient in the pharmaceutical care module. Patient's case notes and the information gathered from the patient through the interview was used to devise a pharmaceutical attention plan for the individual. Initially, I did not understand how consultations between prescribers and patients happen. The latest models of of consultations were introduced in the prescribing technology module. I also read section on scientific decision making and proof founded prescribing from the publication on non-medical prescribing which provided me an intensive knowledge of prescriber's consultations. Of the many modules I learned that Calgary-Cambridge observation guides and the SEGUE construction are usually used to teach health care specialists. Subsequently after going through the consultation models, I understood a patient appointment in framework of medical prescribing is very different. In a general pharmacist-patient relationship the emphasis is more on determining issues of what other therapies which could improve patient compliance and health generally. Prescriber's discussion such as conformity associated with medications and pondering with medications and any review kind of assessment the emphasis is more on the type of consultation were released to
By studying At first I was not certain of what specialized medical aspects meant and why are they important in non medical prescriber's consultations. The book on non -medical prescribing provided me a insight into clinical decision making. I became aware that medical aspects involve identification, medical management and further monitoring of the condition. I felt that medical aspects are really important especially in consultations including independent prescriber. The explanation for it being the activities of indie prescriber is not checked by anyone else. In case there is supplementary prescribing any action regarding prescribing such as starting new medication or change of dose of by the supplementary prescriber must be agreed upon by the unbiased prescriber on the clinical management plan. Hence, getting a sound scientific and pharmaceutical knowledge is very essential competency necessary for a prescriber which is vital in case of impartial prescriber. The countrywide prescribing centre also has competency framework for supplementary prescribers which are different than independent prescribers. This made me realize the increased responsibility of any non -medical self-employed prescriber in comparison with a supplementary prescriber who are only confined to the specialized medical management plan.
A extensive reading of the competency framework put in place by the National prescribing centre for self-employed pharmacist prescribers offered me a in-depth understanding of the competencies necessary for appointment. The competencies involved with the discussion included Clinical and pharmaceutical knowledge. I realized that the prescriber must have up-to-date clinical and pharmaceutical knowledge of their portion of competence and also about the relevant products used in the treatment. They must be able to identify any ADR's, medication connections associated and also identify any drugs which may be possibly abused. The prescriber will need to have knowledge about the pharmacological aspects of the medicine such as its mechanism of action, pharmacokinetics and exactly how these can be afflicted in specific patients such as elderly and patients which other problems like liver organ or renal impairment.
I also learnt that, the prescriber must maintain a posture to consider all treatment plans such as non pharmacological and pharmacological management of the problem. He or she should be able to take patients earlier health background, medication record and other aspects such as OTC medication when making a specialized medical decision about the medication choice. The prescriber can use equipment to make any clinical prognosis and suggest or interpret any relevant investigations. The prescriber must have the ability to monitor the effectiveness of the procedure and make any required alterations to the medication predicated on the monitoring.
All all these points are the clinical aspects which I think are important in consultations of non- medical prescribers. Account of all the above points along with other competencies in the regions of prescribing effectively and prescribing in framework by non-medical prescribers will lead to safe and effective prescribing. However, I noticed from the competency framework document that apart from the scientific aspects there are other aspects of consultation that happen to be also important involved with prescriber appointment and