Pharmacists as independent prescribers in community pharmacy: A scoping review

Abstract

Background: There has been a growing interest in granting prescribing rights to pharmacists as a strategy to improve healthcare access. Researchers continue to explore the impact and implementation of pharmacist prescribing. Given the recent international changes in this field, an overview of current territories allowing pharmacist independent prescribing would provide a comprehensive understanding for researchers and policymakers.

Aim: This scoping review aims to summarize the countries and specific jurisdictions where pharmacists can prescribe independently in community pharmacy, and map the conditions they can prescribe for, required training, and reimbursement policies.

Method: This scoping review was conducted in October 2024 and has been reported following the PRISMA-ScR guidelines. Searches were performed in Scopus, Web of Science, CINAHL, PubMed, and Cochrane databases, along with grey literature searches using Google.

Results: A total of 88 studies and reports were identified. The countries where pharmacist can prescribe independently include the United Kingdom, the United States, Canada, Australia, Poland, Switzerland, and Denmark. Pharmacists authorized as independent prescribers generally require post-registration training and are authorized to initiate, adapt, renew, or substitute prescriptions. For the payment and reimbursement, this service is publicly funded only in Canada, Denmark, France, and the United Kingdom.

Conclusion: Pharmacist prescribing practices vary significantly worldwide, with differences in terminology, legislation, and training requirements. This scoping review provides the necessary information to visualize and conceptualize the current scope of pharmacist independent prescribers, offering a foundation for advancing this practice in new jurisdictions. Further research should address current models in under-studied regions, explore the scope for pharmacists to prescribe for undiagnosed conditions, and analyze payment structures in non-funded jurisdictions.