Hospital doctors' perceived barriers to pharmacist prescribing

Objective - To examine the reasons behind hospital doctors' perceived barriers to pharmacist prescribing in the United Kingdom. Method - Postal questionnaires using a combination of open and closed questions were sent to hospital doctors seeking responses to scenarios describing pharmacists writing prescriptions for drug treatment. Content analysis of the qualitative responses was undertaken to identify the major themes which represented potential barriers. Setting - Five National Health Service teaching hospitals in Birmingham, UK. Key findings - Completed questionnaires were received from 94/193 doctors (49 per cent). Fifty-two respondents (55 per cent) expanded on their opinions in responding to the scenarios presented. Thirty-eight respondents described potential problems or gave reasons why they believed pharmacists should not be permitted to transcribe or prescribe drug treatment. Eleven respondents spontaneously added supportive comments and the remainder were neutral. Five major themes clearly emerged: pharmacists' awareness of clinical and patient details, potential communication problems, belief that a doctor should write the initial inpatient prescription, the division of overall clinical responsibility and loss of the opportunity to review the drug treatment. Conclusion - Potential barriers to pharmacist prescribing were identified both by doctors who agreed and by doctors who disagreed with the general concept. Some doctors had misconceptions about the division of responsibility relating to drug treatment. This study has identified important issues that the pharmacy profession will need to address if we are to be accepted as prescribers and provides a valuable starting point for further work.