Table 5 A full summary of the data on the factors influencing the successful implementation and/or delivery of non-medical prescribing services
From: Exploring non-medical prescribing for patients with mental illness: a scoping review
| Â | Barriers to implementing and/or delivering non-medical prescribing services | |
|---|---|---|
NMP type | Country | Â |
Nurse | UK | • Lack of the appropriate training and time [21, 52] • Lack of medical support/ supervision [25, 36] • Hard to meet the criteria for nursing prescribing programme [36] • No clear structure [21] (e.g., policies and clinical governance) [25] and absence of well-defined approach to implement [36] • Funding relating to training programme [36] • Lack of financial remuneration [21, 25] • Unclarity around the role of NMPs (job description) [21, 25] • Restriction with supplementary prescribing [59] • The reaction of medical colleagues towards nurse prescribing (doctor threatened by nurse being prescriber) [59] • Fears of re-located from community to more specialised clinic [59] • Nurse prescriber not seen competent as medical prescriber [59] • Inability to access to prescription pads [25] • Lack of communication and information dissemination [25] • Prescribing from limited formulary [64] • Shortage of staff [87] • Issue with Continuing Professional Development [87] • Not able to deal with case complexity thoroughly due to lack the time [87]. |
USA | • Supervision related issue [9] • Low salary and incentives [77] • Nurse prescriber not seen competent as medical prescriber [77] • Lack of confidence in managing the risk associated with antipsychotics medications [80]. | |
Ethiopia | • Low salary [74] • Absence of the essential drug in place [74] | |
NMP type | Country | Â |
Pharmacist | UK | • Constraints of the space in practice [38] • Difficulties in accessing both electronic health records and prescription [38] • lack of understanding of pharmacist role (from patients) [84] • long-time taking in reviewing Z-Drug (e.g., a class of medicines that are primarily used as sedative-hypnotics) [84] |
|  | USA | • Difficulty associated with timely collection and reporting of Absolute Neutrophil Counts (ANC) to the pharmacy [86]. • Concern related to tolerability and side effects of clozapine [86]. • Inadequate knowledge in managing clozapine side effects and clinic procedure [86]. • Lack of written materials for patient education and lack of experience with clozapine prescribing [86]. • Not fully familiar with clozapine prescribing guidelines [86]. |
Both | UK | • The difficulty associated with the electronic system [37] • Lack of the appropriate training and time (with benzodiazepine prescription) [37] • No clear structure of CPD [37] • Lack of support and supervision [37] |
| Â | Facilitators to implementing and/or delivering non-medical prescribing services | |
NMP type | Country | Â |
Nurse | UK | • Availability of a lead person to support nurse prescribing practice [36] • Availability of defined formularies in place [43] |
|  | USA | • Educational activities for continuing education (CE) Credits [80]. • Reading both journal articles and textbooks [80]. • Consulting with specialists [80]. • Attending conferences [80]. • Content in NP program [80]. • Having a pharmaceutical representative [80]. |
Pharmacist | USA | • Having ongoing clozapine education [86]. • Adequate administrative support (for managing the REMS registry and initiating clozapine) [86]. |
Both | UK | • Availability of several guidance and publications sources [49]. |