In recent years, a significant change in the pharmacist’s scope of practice is the expansion of prescriptive authority (PA). In Saskatchewan, pharmacists adopted an interdependent prescribing model to support interprofessional collaboration, public safety though the optimal use of drug therapy, and the optimization of pharmacy competencies. In acquiring this new prescriptive authority, the community pharmacist also assumes new responsibilities and obligations, as well as transforming their relationships with patients and physicians. The purpose of this research is to assess rates of adoption by pharmacists of PA (Level 1 and Minor Ailments Prescribing) within community pharmacy practice in Saskatchewan. To gain a better understanding of how pharmacists are responding to new and evolving models of practice, this study proposes to measure their experiences with PA services and how it is affected by aspects of their professional practice. To investigate the study’s research questions, a cross-sectional study using a mail-in questionnaire with an online option was initiated. All registered community pharmacists in Saskatchewan (998) were asked to participate in the study. Of the 998 distributed questionnaires, 501 were returned back by the respondents yielding a response rate of 51.3 percent. The results disclose that a vast majority of respondents agreed or strongly agreed that they were confident in their ability to provide Level 1 (94%) and Minor Ailment (75%) prescribing. Respondents indicated that 74.2 percent of the time they actually provide Level 1 (L1) prescribing services to their patients and slightly more than half (52.5%) of the time provided Minor Ailment (MA) prescribing services. The majority of respondents (81.4 %) indicated that on average it took twenty minutes or less to provide MA prescribing service to their patients. Most pharmacist respondents strongly supported the statement that the pharmacies they worked at consistently provided Prescriptive Authority services (L1- 90% Strongly Agreed or Agreed, MA- 52.9% Strongly Agreed or Agreed) and that they get full support from managers (L1- 95.6% Strongly Agreed or Agreed, MA- 88% Strongly Agreed or Agreed) for their involvement in PA services. Respondents indicated some concern regarding the limited knowledge of patients on what pharmacists can do for them as a prescriber. In terms of overall relationships with patients, respondents indicated that patients were satisfied with the services pharmacists provide as a prescriber. Respondents reported that they had a good relationship with physicians. However, they did express concerns about their limited interactions with physicians as MA prescribers. Respondents generally reported supportive environments and positive interactions with patients and physicians. However, while expressing confidence in their ability to provide all prescriptive authority services, Level 1 services that supported traditional dispensing services were generally more consistently provided, supported, and perceived as being valued by patients and physicians compared to Minor Ailment Prescribing. The results also support the notion that pharmacists are highly confident to provide PA services to the patients and their relationships with the patients and physician improved day by day. Nevertheless, there is little evidence to suggest that patient’s level of knowledge about pharmacist’s new role; pharmacist’s interaction with physicians and physicians’ knowledge on PA have affected the provision of Prescriptive Authority services.

The prescriptive authority for psychologists (RxP) movement contends that psychologists who receive specialized training should attain licensure to prescribe psychotropic medication. The RxP movement has presently culminated in psychologists in the United States prescribing at both the state and federal levels. However, the RxP movement remains contentious, and both supporters and opponents continue to disagree over its validity as a professional movement. Division 17 of the American Psychological Association, the counseling psychology specialty’s professional organization, has not officially discussed the RxP movement since 1994. Given the developments within the RxP movement since then, this study endeavored to investigate the current perceptions of prescriptive authority among the Executive Board leadership of Division 17. Researchers conducted semi-structured interviews with current and former members of the Executive Board and then used a consensual qualitative research (CQR) methodology to qualitatively generate findings across participants’ responses. Participants shared qualified support of prescriptive authority, despite indicating no interest in prescribing themselves, and they reported that they saw prescriptive practice as consistent with the professional identity of counseling psychology. Participants also suggested that Division 17 could proceed with the RxP movement by developing a Special Task Group (STG) to investigate prescriptive authority among its members. These conclusions indicate that members of the Executive Board are well positioned to lead Division 17 forward in addressing prescriptive authority by creating a STG to further explore the issue for counseling psychology.

Bakgrund: I Sverige får distriktsköterskor, barnmorskor och sjuksköterskor med särskild utbildning skriva ut ett begränsat antal läkemedel. Forskning visar att förskrivning från sjuksköterska inom somatisk vård har fungerat väl. I flera länder omfattas även psykiatriska läkemedel i sjuksköterskans förskrivningsrätt. Psykiatriska tillstånd har ökat i Sverige under 2000-talet och behandlas i många fall med läkemedel. Svenska psykiatrisjuksköterskor har dock inte förskrivningsrätt. Författarna vill med denna uppsats belysa erfarenheter från de länder där sjuksköterskor inom psykiatrisk vård har förskrivningsrätt.  Syfte: Syftet var att beskriva erfarenheter av psykiatrisjuksköterskors förskrivningsrätt av läkemedel.  Metod: Litteraturöversikt med systematisk. Litteratursökningen genomfördes i PubMed, CINAHL och PsycINFO och sammanlagt 12 vetenskapliga kvalitativa originaltitlar inkluderades i resultatet. Resultat: Förskrivningsrätt för sjuksköterskor inom psykiatri bidrog till att vården och yrkesrollen förändrades vilket ledde till en ökad helhetssyn och personcentrerad vård samt förbättrade tillgängligheten och följsamheten. Relationer inom vården förändrades mellan patient, sjuksköterska och läkare. Patienter upplevde att de var välinformerade när sjuksköterska förskrev och övriga behandlingsalternativ övervägdes i större utsträckning. Handledning från erfarna förskrivare lyftes fram som en framgångsfaktor. Slutsats: Erfarenheter av psykiatrisjuksköterskors förskrivningsrätt visade att vården förändrades ifrån flera perspektiv. Även yrkesrollen förändrades till att bli mer självständig vilket inkräktade på sjuksköterskans vårdande roll och påverkade hierarkier inom vården. / Background: In Sweden district nurses, midwives, and nurses with special training may prescribe a limited number of pharmaceuticals. Research has shown that prescriptive authority for nurses in somatic care has been successful. In several countries, psychiatric drugs are also covered by nurses’ prescriptive authority. Psychiatric conditions have increased in Sweden during the 21st century and are in many cases treated with medication. However, Swedish specialist nurses in psychiatric care do not have prescriptive authority. The authors of this essay want to highlight experiences from countries where psychiatric nurses have prescribing rights. Aim: The aim was to describe experiences of psychiatric nurses' prescription authority. Method: Literature review with a systematic approach. The literature search was conducted in PubMed, CINAHL, and PsycINFO, and a total of 12 scientific qualitative original titles were included in the results. Results: Prescriptive authority for nurses in psychiatric care contributed to changes in healthcare and the nursing profession, which led to an increased holistic approach and person-centered care, as well as improved accessibility and compliance. Relationships within healthcare changed between patients, nurses, and doctors. Patients felt well-informed when nurses prescribed, and other treatment options were considered to a greater extent. Guidance from experienced prescribers was highlighted as a success factor. Conclusion: Experiences of psychiatric nurses' prescription authority demonstrated that healthcare underwent changes from multiple perspectives. The nurses’ professional role also transformed to becoming more independent, which encroached upon the nurse’s caring role and impacted hierarchies within healthcare.

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