Academic Journal

Effectiveness and safety of pharmacist prescribing: a systematic review.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Effectiveness and safety of pharmacist prescribing: a systematic review.
Συγγραφείς: Teahan Á; Evidence Centre, Health Research Board, Dublin, Ireland ateahan@hrb.ie., Sharp M; Evidence Centre, Health Research Board, Dublin, Ireland., Farragher A; Evidence Centre, Health Research Board, Dublin, Ireland., Strawbridge J; School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland., Long J; Evidence Centre, Health Research Board, Dublin, Ireland.
Πηγή: BMJ open [BMJ Open] 2026 Jun 25; Vol. 16 (6), pp. e112886. Date of Electronic Publication: 2026 Jun 25.
Τύπος έκδοσης: Journal Article; Systematic Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
Ιατρικοί όροι (MeSH): Drug Prescriptions*/standards , Pharmacists* , Practice Patterns, Pharmacists'*, Humans ; Non-Medical Prescribing ; Professional Role ; Patient Safety
Περίληψη: Objective: To examine the effectiveness and safety of pharmacist prescribing across multiple healthcare settings.
Design: A systematic review of quantitative studies.
Eligibility Criteria for the Selection of Studies: Quantitative studies assessing the effectiveness and safety of pharmacist prescribing compared with non-pharmacist prescribing in any healthcare setting and for any healthcare population. A clear statement of pharmacists' prescriptive authority was required for inclusion in this systematic review.
Data Sources: A systematic search was conducted using six electronic databases: Embase (Ovid), MEDLINE (EBSCO), SCiELO, Dimensions AI, Cochrane Library and Epistemonikos. Database searches were conducted from database inception to 29 January 2025. Additional grey literature searches were conducted using Google and DuckDuckGo. Both backward and forward citation chasing were conducted for all included studies.
Data Extraction and Synthesis: Data were extracted using standardised bespoke data extraction forms. The revised Cochrane Risk of Bias 2 tool for randomised controlled trials and the Risk of Bias in Non-Randomised Studies of Interventions tool were used to assess risk of bias. A narrative synthesis approach was applied following the Synthesis Without Meta-analysis guideline. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the level of certainty of the evidence.
Results: Of the 39 included studies, 32 studies reported on effectiveness and 20 studies reported on safety across 15 health conditions. Healthcare settings included outpatient (n=14), primary care (n=10), community pharmacy (n=6), inpatient (n=5), emergency department (n=1) and long-term care (n=3). These studies were based in the USA (n=26), Canada (n=5), the UK (n=4), Australia (n=2) and Singapore (n=2). In total, there were 153 outcomes related to safety and effectiveness. For 74 outcomes, no significant difference was reported between pharmacist prescribing and non-pharmacist prescribing, while 46 outcomes were significantly improved with pharmacist prescribing. Four outcomes reported in favour of non-pharmacist prescribing. Inferential statistics were not reported for 29 outcomes, meaning we cannot comment on their statistical significance. The certainty of evidence was low or very low for all outcomes.
Conclusions: The consistency of effectiveness and safety findings across studies, showing either no significant difference (indicating equivalence of care and outcomes) or significant improvement in pharmacist prescribing groups, suggests it is a potential policy option. Future research on implementation, public and patient preferences and cost-effectiveness would provide valuable insights into the potential benefits of pharmacist prescribing at a health system level.
(© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.)
Competing Interests: Competing interests: None declared.
Contributed Indexing: Keywords: Pharmacists; Prescriptions; Systematic Review
Entry Date(s): Date Created: 20260625 Date Completed: 20260626 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13311757
DOI: 10.1136/bmjopen-2025-112886
PMID: 42350016
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2044-6055
DOI:10.1136/bmjopen-2025-112886