Attitudes of pharmacists in Croatia towards the independent pharmacist prescribing program

Abstract

Posljednjih desetljeća farmaceutska struka prolazi kroz značajne promjene diljem svijeta, s naglaskom na proširenje uloga ljekarnika izvan tradicionalnih okvira izdavanja lijekova. Jedan od smjerova takvih promjena je i koncept samostalnih farmaceuta propisivača (eng. Independent pharmacist prescriber) koji je uspješno implementiran u nekoliko zemalja svijeta. Samostalnim farmaceutima propisivačima u Velikoj Britaniji, u 2024. godini, dopušteno je procijeniti pacijente, postaviti dijagnozu i propisati lijek za bilo koje stanje ili bolest (isključujući diamorfin, kokain i dipipanon), te za bilo kojeg pacijenta unutar njihovih kliničkih kompetencija. Opseg djelovanja ovih farmaceuta širok je i obuhvaća rad na razini primarne i sekundarne zdravstvene zaštite. Cilj ovog istraživanja bio je utvrditi stavove hrvatskih ljekarnika prema programu samostalnih farmaceuta propisivača (eng. Independent pharmacist prescriber). Putem on-line anketnog upitnika ispitanici su mogli izraziti svoje stavove prema programu, njegovim prednostima i nedostatcima, ali i njegovoj potencijalnog implementaciji i izvođenju u Republici Hrvatskoj. U istraživanju je sudjelovalo 455 ispitanika, od kojih je 82,6% bilo žena, a 17,4% muškaraca, te je medijan dobi iznosio 34 godine. Većina ispitanika (85,5%) smatra da bi propisivanje lijekova od strane farmaceuta imalo pozitivan utjecaj na zdravstveni sustav. Također, svaka navedena prednost ocijenjena je većinski kao iznimno važna. „Neprihvaćanje od strane liječnika“ hrvatski su ljekarnici ocijenili kao najveću prepreku u okviru potencijalne implementacije programa, a „Vremenska ograničenja“ kao najmanju. Gotovo su svi ispitanici smatrali kako uloga farmaceuta kao propisivača lijekova predstavlja profesionalno napredovanje, a 63,5% ispitanika u potpunosti se složilo kako bi postali samostalni farmaceuti propisivači, kada bi to bila mogućnost. Dodatna obuka nakon fakulteta, specijalistički studij i kurikulum fakulteta bili su najčešći odgovori na pitanje gdje i na koji način bi se trebala odvijati obuka za stjecanje titule samostalnog farmaceuta propisivača. Zaključno, stav hrvatskih ljekarnika prema programu samostalnih farmaceuta propisivača (eng. Independent pharmacist prescriber) vrlo je pozitivan i optimističan, a približno dvije trećine ljekarnika izrazilo je želju za postizanjem titule samostalnog farmaceuta propisivača. Ovi rezultati sugeriraju želju hrvatskih ljekarnika za daljnjim napredovanjem i usavršavanjem, te upućuju na potrebu za raspravom o potencijalnim proširenjima uloga ljekarnika u sklopu hrvatskog zdravstvenog sustava.In recent decades, the pharmaceutical profession has undergone significant changes worldwide, with a focus on expanding the roles of pharmacists beyond the traditional framework of dispensing medications. One direction of these changes is the concept of independent pharmacist prescribers, which has been successfully implemented in several countries worldwide. In the UK, as of 2024, independent pharmacist prescribers are allowed to assess patients, diagnose, and prescribe medications for any condition or illness (excluding diamorphine, cocaine, and dipipanone), as well as for any patient within their clinical competence. The scope of these pharmacists' work is broad, covering both primary and secondary healthcare. The aim of this research was to determine the attitudes of Croatian pharmacists towards the independent pharmacist prescriber program. Through an online survey, respondents were able to express their views on the program, its advantages and disadvantages, as well as its potential implementation and execution in Croatia. The study involved 455 respondents, 82.6% of whom were women, and 17.4% men, with a median age of 34. Most respondents (85.5%) believe that pharmacist prescribing would have a positive impact on the healthcare system. Additionally, all listed advantages were predominantly rated as extremely important. "Lack of acceptance by doctors" was seen by Croatian pharmacists as the biggest obstacle to the potential implementation of the program, while "Time constraints" were considered the smallest obstacle. Nearly all respondents believed that the role of pharmacists as prescribers represents professional development, and 63.5% strongly agreed that they would become independent pharmacist prescribers if given the opportunity. Postgraduate training, specialist studies, and university curriculum were the most common answers regarding how and where the training for achieving the title of independent pharmacist prescriber should take place. In conclusion, the attitudes of Croatian pharmacists towards the independent pharmacist prescriber program are very positive and optimistic, with approximately two-thirds expressing a desire to obtain the title. These results suggest a strong willingness for further professional development and point to the need for discussions on potential expansions of pharmacists' roles within the Croatian healthcare system