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Open Access Highly Accessed Study protocol

Effects of prescription adaptation by pharmacists

Michael R Law1*, Steven G Morgan2, Sumit R Majumdar3, Larry D Lynd4 and Carlo A Marra4

Author Affiliations

1 Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia. 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada

2 Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia. 201-2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada

3 Division of General Internal Medicine, Department of Medicine, University of Alberta. 2E3.07 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada

4 Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, The University of British Columbia and Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute. 2146 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada

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BMC Health Services Research 2010, 10:313  doi:10.1186/1472-6963-10-313

Published: 17 November 2010

Abstract

Background

Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use.

Methods/Design

We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals.

Discussion

In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based.