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International Journal of Clinical Pharmacy

, Volume 38, Issue 4, pp 960–967 | Cite as

Stakeholders’ views on granting prescribing authority to pharmacists in Nigeria: a qualitative study

  • Asa AutaEmail author
  • Barry Strickland-Hodge
  • Julia Maz
Research Article

Abstract

Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients’ access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders’ views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders’ perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients’ access to medicines, reduce doctors’ workload and promote the utilisation of pharmacists’ skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists’ inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all stakeholders acknowledged the potential of pharmacist prescribing to increase patients’ access to medicines in Nigeria.

Keywords

Access to medicines Nigeria Patient representatives Pharmacists Pharmacist prescribing Physicians Policymakers 

Notes

Acknowledgments

The authors would like to thank all participants for their valuable time and contributions to this research.

Funding

No financial support was obtained for this study.

Conflicts of interest

The authors do not have any conflict of interest to declare.

References

  1. 1.
  2. 2.
    Kroezen M, Van Dijk L, Groenewegen PP, Francke AL. Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature. BMC Health Serv Res. 2011;11:127.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Stewart D, MacLure K, George J. Educating nonmedical prescribers. Br J Clin Pharmacol. 2012;74(4):662–7.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Bhanbhro S, Drennan VM, Grant R, Harris R. Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature. BMC Health Serv Res. 2011;11:330.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Tonna AP, Stewart D, McCaig D. An international overview of some pharmacist prescribing models. J Malta Coll Pharm Pract. 2008;14:20–6.Google Scholar
  6. 6.
    Pharmacy Council of New Zealand. Pharmacist Prescribers. http://www.pharmacycouncil.org.nz/cms_display.php?st=1&sn=232. Accessed 30 Mar 2016.
  7. 7.
    Yariv H. The case of pharmacist prescribing policy in Israel. Isr J Health Policy Res. 2015;4(1):49.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Nissen L. Hospital talk: pharmacist prescribing-the perfect storm? Aust J Pharm. 2014;95:29.Google Scholar
  9. 9.
    National Drug Policy-Nigeria. Abuja: Federal Ministry of Health, Nigeria and World Health Organisation; 2005. http://apps.who.int/medicinedocs/documents/s16450e/s16450e.pdf. Accessed 30 Mar 2016.
  10. 10.
    Ehiri JE, Oyo-Ita AE, Anyanwu EC, Meremikwu MM, Ikpeme MB. Quality of child health services in primary health care facilities in south-east Nigeria. Child Care Health Dev. 2005;31(2):181–91.CrossRefPubMedGoogle Scholar
  11. 11.
    Access to and rational use of medicines at the facility level. Abuja: Federal Ministry of Health, Nigeria; 2010.Google Scholar
  12. 12.
    Babalola CP, Awoleye SA, Akinyemi JO, Kotila OA. Evaluation of prescription pattern in Osun State (Southwest) Nigeria. J Public Health Epidemiol. 2011;3(3):94–8.Google Scholar
  13. 13.
    Fagbule D, Kalu A. Case management by community health workers of children with acute respiratory infections: implications for national ARI control programme. J Trop Med Hyg. 1995;98(4):241–6.PubMedGoogle Scholar
  14. 14.
    Akande T. Referral system in Nigeria: study of a tertiary health facility. Ann Afr Med. 2004;3(3):130–3.Google Scholar
  15. 15.
    Oyedeji R, Abimbola S. How tertiary hospitals can strengthen primary health care in Nigeria. Nig Med J. 2014;55(6):519–20.CrossRefGoogle Scholar
  16. 16.
    Umar I, Oche MO, Umar AS. Patient waiting time in a tertiary health institution in Northern Nigeria. J Public Health Epidemiol. 2011;3(2):78–82.Google Scholar
  17. 17.
    Ajayi IO. Patients’ waiting time at an outpatient clinic in Nigeria—can it be put to better use? Patient Educ Couns. 2002;47(2):121–6.CrossRefPubMedGoogle Scholar
  18. 18.
    World Bank. Physicians (per 1000 people). http://data.worldbank.org/indicator/SH.MED.PHYS.ZS. Accessed 30 Mar 2016.
  19. 19.
    Oche M, Adamu H. Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria. Ann Med Health Sci Res. 2014;3(4):588–92.Google Scholar
  20. 20.
    Alo A. Pharmacy in Nigeria. Am J Health Syst Pharm. 2006;63:670–3.CrossRefPubMedGoogle Scholar
  21. 21.
    WAPCP Listing of fellows of the college (1991–2011). http://www.wapcp.info/sites/default/files/news_attachments/wapcp_listing_of_fellows1991-2011.pdf. Accessed 1 Feb 2013.
  22. 22.
    Auta A, Maz J, Strickland-Hodge B. Perceived facilitators to change in hospital pharmacy practice in England. Int J Clin Pharm. 2015;37(6):1068–75.CrossRefPubMedGoogle Scholar
  23. 23.
    Erhun WO, Osigbesan T, Awogbemi JK. Study of pharmacists’ and physicians’ views on pharmacists prescribing in Nigeria. West Afr J Pharm. 2013;24(2):76–82.Google Scholar
  24. 24.
    Auta A, Bala ET, Shalkur D. Generic medicine substitution: a cross-sectional survey of the perception of pharmacists in North-Central, Nigeria. Med Princ Pract. 2014;23(1):53–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Auta A, Fredrick NC, David S, Banwat SB, Adeniyi MA. Patients’ views on their consultation experience in community pharmacies and the potential prescribing role for pharmacists in Nigeria. J Pharm Health Serv Res. 2014;5:233–6.CrossRefGoogle Scholar
  26. 26.
    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRefGoogle Scholar
  27. 27.
    De Vries T, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing. A Practical Manual. Geneva: World Health Organization Action Programme on Essential Drugs; 1994.Google Scholar
  28. 28.
    Nissen L. Pharmacist prescribing: what are the next steps? Am J Health Syst Pharm. 2011;68(24):2357–61.CrossRefPubMedGoogle Scholar
  29. 29.
    Kondro W. Canada’s doctors assail pharmacist prescribing. CMAJ. 2007;177(6):558.Google Scholar
  30. 30.
    Gilbert L. Pharmacy’s attempts to extend its roles: a case study in South Africa. Soc Sci Med. 1998;47(2):153–64.CrossRefPubMedGoogle Scholar
  31. 31.
    Britten N. Prescribing and the defence of clinical autonomy. Sociol Health Illn. 2001;23(4):478–96.CrossRefGoogle Scholar
  32. 32.
    Eaton G, Webb B. Boundary encroachment: pharmacists in the clinical setting. Sociol Health Illn. 1979;1(1):69–89.CrossRefPubMedGoogle Scholar
  33. 33.
    South African Pharmacy Council. Scope of practice and qualification for authorised pharmacist prescriber. Board Notice 122 of 2011. Government Gazette No. 34428.Google Scholar
  34. 34.
    Stewart DC, George J, Bond CM, Diack HL, McCaig DJ, Cunningham S. Views of pharmacist prescribers, doctors and patients on pharmacist prescribing implementation. Int J Pharm Pract. 2009;17(2):89–94.CrossRefPubMedGoogle Scholar
  35. 35.
    Courtenay M, Carey N, Stenner K, Lawton S, Peters J. Patients’ views of nurse prescribing: effects on care, concordance and medicine taking. Br J Dermatol. 2011;164(2):396–401.CrossRefPubMedGoogle Scholar
  36. 36.
    Nigeria Demographic and Health Survey 2008. Abuja: National Population Commission and ORC Macro, 2009. http://www.dhsprogram.com/pubs/pdf/FR222/FR222.pdf. Accessed 30 Mar 2016.
  37. 37.
    Ward K, Sanders D, Leng H, Pollock AM. Assessing equity in the geographical distribution of community pharmacies in South Africa in preparation for a national health insurance scheme. Bull World Health Organ. 2014;92(7):482–9.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Oparah AC, Arigbe-Osula EM. Evaluation of community pharmacists’ involvement in primary health care. Trop J Pharm Res. 2002;1(2):67–74.CrossRefGoogle Scholar
  39. 39.
    World Health Organization. Nigeria still searching for right formula. 2015. http://www.who.int/bulletin/volumes/86/9/08-020908/en/. Accessed 22 June 2015.
  40. 40.
    Pharmacists Council of Nigeria. Full registration list of Pharmacists as at 2nd October, 2014. http://pcn.gov.ng/WEB%20full%20registration%20list.pdf. Accessed 11 Nov 2014.

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  1. 1.School of Pharmacy and Biomedical SciencesUniversity of Central LancashirePrestonUK
  2. 2.School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
  3. 3.Centre for Technology Enabled Health Research, Faculty of Health and Life SciencesCoventry UniversityCoventryUK

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