Medicines Optimisation and Prescribing in Complex Patients

These flashcards cover key topics about pharmacist prescribing, including historical context, legislation, and responsibilities related to prescribing practices.

What were the initial purposes of regulating medicines in England and the UK?

To raise government revenue, discourage murder by poisoning, and regulate the activities of pharmacists.

Supplementary Prescribing

A voluntary prescribing partnership between an independent prescriber (doctor or dentist) and a supplementary prescriber to implement an agreed patient-specific clinical management plan with the patient’s agreement

What is the purpose of a Clinical Management Plan (CMP) in supplementary prescribing?

It outlines the prescribing rights and responsibilities between an independent prescriber and a supplementary prescriber for a patient-specific clinical management.

When was independent prescribing for District Nurses and Health Visitors first established?

In 1992.

What is one significant change regarding pharmacist supplementary prescribers enacted in 2006?

Legislation was enacted to allow independent prescribing by nurses and pharmacists, superseding supplementary prescribing.

What is the difference between supplementary prescribing and independent prescribing?

Supplementary prescribing is a partnership where prescribing is based on a Clinical Management Plan, while independent prescribing involves a prescriber making decisions without needing to consult another prescriber.

Who can be a supplementary prescriber?

Registered nurses, midwives, pharmacists, optometrists, and allied healthcare professionals.

What year did the NHS Plan highlight nurse prescribing as a key role?

In the year 2000.

What document recommended extending prescribing rights for health professionals to benefit patients?

The Crown Report (1999).

What are the professional groups that can perform supplementary prescribing?

Dieticians, nurses, optometrists, paramedics, pharmacists, physiotherapists, and radiographers.

What are the advantages of independent prescribing for pharmacists?

Pharmacists can manage patient care more autonomously, having the ability to diagnose and prescribe within their professional competence.

What question regarding prescribing practices should pharmacists ask themselves before prescribing?

Am I prescribing in line with clinical and national guidelines?

What should an independent prescriber ensure before making a prescribing decision?

They must ensure they have all necessary information to prescribe safely and act within their knowledge and competence.

What significant report paved the way for limited prescribing by health visitors and district nurses?

The Cumberlege Report (1986).

What was one of the key changes for pharmacist prescribers in the 2024 academic year?

Funding was announced to allow more current pharmacists to apply for independent prescriber training places.

How often should a supplementary prescriber monitor a patient according to the Clinical Management Plan?

It is stated within the CMP, often suggested to be weekly or as needed.

What are the disadvantages of supplementary prescribing?

• time-consuming

• mostly suited for managing chronic conditions stepwise.

• Necessarily restrictive

What does the term 'independent prescriber' refer to?

An independent prescriber is accountable for the clinical assessment and management of patients without needing to consult another prescriber.

What does the legislation enacted in 2012 regarding nurse prescribing include?

It includes the introduction of the Misuse of Drugs Regulations which extended rights to prescribe controlled drugs.