General Practitioners’ Perspectives on Pharmacist Prescribing in the Netherlands: A Focus Group Study

Abstract

Background: As global populations age, healthcare systems worldwide face rising demands, and, simultaneously, increasing workforce shortages caused by a shrinking working-age population. Recent studies confirm the potential of non-medical prescribers (e.g, pharmacists) to alleviate healthcare strain, demonstrating effectiveness and safety comparable to prescribing by medical doctors. While research has explored the perspectives of Dutch patients and pharmacists regarding pharmacist prescribing, the perspectives of general practitioners (GPs) have been insufficiently addressed.

Aim: The aim of this study was to investigate the perspectives of GPs on potential pharmacist prescribing in the Netherlands.

Method: PharmacoTherapy Audit Meetings (PTAM) groups were used to conduct focus groups that included both GPs and pharmacists. Participants jointly discussed the current informal prescribing activities by pharmacists and the collaboration between GPs and pharmacists. Hereafter, group discussions followed, exclusively containing GPs or pharmacists, in which the potential pharmacist prescribing authorities were discussed, including the scope of practice, (dis)agreements and preconditions for implementation. The focus groups were conducted, audio-recorded and transcribed verbatim between September and December 2024. Inductive thematic analysis was performed using NVivo.

Results: Six focus groups with a total of 64 GPs and 19 pharmacists were conducted and analysed. Three main themes were identified. First, “Current practice: trust-based collaboration with a core position for the GP” describes the pharmacist’s current role in informal prescribing relative to the GP’s central role. Second, “Pharmacist prescribing model based on the collaborative starting position” addresses mixed views on what pharmacist prescribing should entail. In contrast, there is consensus among GPs on national legalization of current informal practices and a scope of practice guided by local collaboration. Finally, “Requirements for the introduction of pharmacist prescribing” such as regulation, pharmacist competencies and interoperability of information systems - along with proper feedback to the GP - should be addressed.

Conclusion: This study demonstrated that collaboration and trust between GPs and pharmacists creates a foundation for a defined prescribing role for pharmacists. Legalization of current informal prescribing practices with the scope of prescribing being determined by local collaborative agreements seems appropriate. Certain key conditions, such as the interoperability of information systems, should be addressed though before its introduction.