Sir, – Following Minister for Health Stephen Donnelly’s announcement, there is now an opportunity for pharmacists to be empowered to prescribe in Ireland (“Allowing pharmacists to extend prescriptions is under examination by new taskforce”, News, July 23rd).
This is an important policy change. Nurses have been legally empowered to prescribe since 2011, and extending prescriptive powers to pharmacists is common sense.
Most of the discussion so far has been about the community pharmacy, but hospital pharmacists have an even greater opportunity to enhance care quality and safety for patients, both while attending hospital, and in the critical transitions of care from hospital inpatient wards to home or to residential care.
There are high levels of prescribing error in the current Irish system when patients transition in an out of care settings. There is Irish research evidence that pharmacists with prescribing authority can address many of these problems and prevent harmful prescribing errors.
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The research is cited in the 2019 World Health Organisation (WHO) technical report Medication Safety at Transitions of Care. That report was published as part of the WHO Global Patient Safety Challenge: Medication Without Harm. Its main author Ciara Kirke, an Irish pharmacist, is the HSE clinical lead for medication safety.
Successful policy change depends on the readiness of the players. There is evidence that most hospital pharmacists currently working in Ireland want prescriptive authority now.
A 2021 survey of 689 registered hospital pharmacists by the UCC School of Pharmacy yielded 284 eligible responses. Most non-prescribing pharmacists said they would like a prescribing role and felt underutilised by not having prescribing authority (84 per cent). These respondents believed that pharmacist prescribing allowed for increased workflow efficiency, faster error correction, along with increased professional autonomy and job satisfaction. They perceived that its routine introduction in Irish hospitals would reduce errors, increase patient safety, reduce other prescribers’ workload, and improve transitions of care. Nearly all (92 per cent) respondents wanted specific legislation to give pharmacists prescribing authority.
The Minister will be pushing an open door if he seeks to implement pharmacist prescribing in hospitals using collaborative models such as the one in place in Tallaght University Hospital, which has the full support of hospital consultants. – Yours, etc,
TIM DELANEY,
Ringsend,
Dublin 4.