Australian podiatrists scheduled medicine prescribing practices and barriers and facilitators to endorsement: a cross-sectional survey

Wiley - Tập 15 - Trang 1-12 - 2022
Kristin Graham1, Lisa Matricciani1,2, Helen Banwell1, Saravana Kumar1, Ryan Causby1, Saraid Martin1, Lisa Nissen3
1Allied Health & Human Performance, The University of South Australia, Adelaide, Australia
2Clinical & Health Sciences, The University of South Australia, Adelaide, Australia
3Faculty of Health, School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia

Tóm tắt

Non-medical prescribing is one healthcare reform strategy that has the potential to create health system savings and offer equitable and timely access to scheduled medicines. Podiatrists are well positioned to create health system efficiencies through prescribing, however, only a small proportion of Australian podiatrists are endorsed to prescribe scheduled medicines. Since scheduled medicines prescribed by Australian podiatrists are not subsidised by the Government, there is a lack of data available on the prescribing practices of Australian podiatrists. The aim of this research was to investigate the prescribing practices among Australian podiatrists and to explore barriers and facilitators that influence participation in endorsement. Participants in this quantitative, cross-sectional study were registered and practicing Australian podiatrists who were recruited through a combination of professional networks, social media, and personal contacts. Respondents were invited to complete a customised self-reported online survey, developed using previously published research, research team’s expertise, and was piloted with podiatrists. The survey contained three sections: demographic data including clinical experience, questions pertaining to prescribing practices, and barriers and facilitators of the endorsement pathway. Respondents (n = 225) were predominantly female, aged 25–45, working in the private sector. Approximately one quarter were endorsed (15%) or in training to become endorsed (11%). Of the 168 non-endorsed respondents, 66% reported that they would like to undertake training to become an endorsed prescriber. The most common indications reported for prescribing or recommending medications include nail surgery (71%), foot infections 474 (88%), post-operative pain (67%), and mycosis (95%). The most recommended Schedule 2 medications were ibuprofen, paracetamol, and topical terbinafine. The most prescribed Schedule 4 medicines among endorsed podiatrists included lignocaine (84%), cephalexin (68%), flucloxacillin (68%), and amoxicillin with clavulanic acid (61%). Podiatrists predominantly prescribe scheduled medicines to assist pain, inflammatory, or infectious conditions. Only a small proportion of scheduled medicines available for prescription by podiatrists with endorsed status were reportedly prescribed. Many barriers exist in the current endorsement for podiatrists, particularly related to training processes, including mentor access and supervised practice opportunities. Suggestions to address these barriers require targeted enabling strategies.

Tài liệu tham khảo

Duckett S, Breadon PJGIR, September. Access all areas: new solutions for GP shortages in rural Australia 2013. McLachlan AJ, Aslani PJAp. National Medicines Policy 2.0: a vision for the future. 2020;43(1):24. Nissen L, Kyle G, Stowasser D, Lum E, Jones A, McLean C, et al. Non-medical prescribing: an exploration of likely nature of, and contingencies for, developing a nationally consistent approach to prescribing by non-medical health professionals-final report 1 June 2010. 2010. Page AT, Cross AJ, Elliott RA, Pond D, Dooley M, Beanland C, et al. Integrate healthcare to provide multidisciplinary consumer-centred medication management: report from a working group formed from the National Stakeholders’ Meeting for the Quality Use of Medicines to Optimise Ageing in Older Australians 2018;48(5):459–46. https://doi.org/10.1002/jppr.1434. Bennett CJFRotNH, Hospitals reform commission C. National Health and Hospitals Reform Commission: A Healthier Future for All Australians. 2009. AHPs into action. Using allied health professions to transform health, care and wellbeing. In: Chief Allied Heath Professions Officer’s Team NE, editor. London 2017. Shaw B, Chisholm OJMJoA. Australia's National Medicines Policy is outdated and in need of review. 2019; 211(6):252–4. e1. Weeks G, George J, Maclure K, Stewart DJCDoSR. Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care 2016(11), 10.https://doi.org/10.1002/14651858.CD011227.pub2. Couch AG, Foo J, James AM, Maloney S, Williams CMJJof, Research a. Implementing a podiatry prescribing mentoring program in a public health service: a cost-description study 2018;11(1):1–8. https://doi.org/10.1186/s13047-018-0282-1. Bennett C, National Health and hospitals reform commission: a healthier future for all Australians. Canberra; 2009. Borthwick AM, Short AJ, Nancarrow SA, Boyce R. Non-medical prescribing in Australasia and the UK: the case of podiatry. J Foot Ankle Res. 2010;3(1):1–10. https://doi.org/10.1186/1757-1146-3-1. (TGA) TGA. The Poisons Standard (the SUSMP). 2021. AHPRA. Registration standard: endorsement for scheduled medicines. In: Australia PBo, editor. 2018. Government of Western Australia. Working with medicines, Podiatrists. In: Health Do, editor. 2017. AHPRA. Podiatry Board of Australia Registrant data. Board P, editor: In; 2021. Liamputtong P. Qualitative data analysis: conceptual and practical considerations. Health Promot J Austr. 2009;20(2):133–9. https://doi.org/10.1071/HE09133. Graham K, Banwell HA, Causby RS, Kumar S, Tian EJ, Nissen L. Barriers to and facilitators of endorsement for scheduled medicines in podiatry: a qualitative descriptive study. J Foot Ankle Res. 2021;14(1):1–11. https://doi.org/10.1186/s13047-021-00457-9. Statistics ABo. 1270.0.55.005 - Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness Structure, 2016 2018 [Available from: https://www.abs.gov.au/ausstats/[email protected]/Latestproducts/1270.0.55.005Main%20Features15July%202016?opendocument&tabname=Summary&prodno=1270.0.55.005&issue=July%202016&num=&view=. Fong J, Cashin A, Buckley T. Models of prescribing, scope of practice, and medicines prescribed, a survey of nurse practitioners. J Adv Nurs. 2020;76(9):2311–22. https://doi.org/10.1111/jan.14444. Currie J, Chiarella M, Buckley T. Privately practicing nurse practitioner services in Australia and patient access to care: results from realist interviews. J Am Assoc Nurse Pract. 2018;30(6):344–53. https://doi.org/10.1097/JXX.0000000000000038. Donovan J, Tsuyuki RT, Al Hamarneh YN, Bajorek B. Barriers to a full scope of pharmacy practice in primary care: a systematic review of pharmacists’ access to laboratory testing. Can Pharm J (Ott). 2019;152(5):317–33. https://doi.org/10.1177/1715163519865759. Fong J, Buckley T, Cashin A. Nurse practitioner prescribing: an international perspective. Nurs Res Rev. 2015;5:99–108. Crawford F, Hollis S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database Syst Rev. 2007;3. https://doi.org/10.1002/14651858.CD001434.pub2. Therapeutic Guidelines Limited. eTG complete [digital] Melbourne [Available from: https://www.tg.org.au. Couch AG, Foo J, James AM, Maloney S, Williams CM. Implementing a podiatry prescribing mentoring program in a public health service: a cost-description study. J Foot Ankle Res 2018;11(1):1–8, 40. https://doi.org/10.1186/s13047-018-0282-1. Deci EL, Ryan RMJPi. The" what" and" why" of goal pursuits: Human needs and the self-determination of behavior. 2000;11(4):227–268. Ryan RM, Deci ELJAp. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. 2000;55(1):68. Maurer T, Allen D, Gatch DB, Shankar P, Sturges DJIJoAHS, practice. Students’ academic motivations in allied health classes 2012;10(1):6. https://doi.org/10.46743/1540-580X/2012.1384. Vansteenkiste M, Aelterman N, De Muynck G-J, Haerens L, Patall E, Reeve JJTJoEE. Fostering personal meaning and self-relevance: A self-determination theory perspective on internalization 2018;86(1):30–49. https://doi.org/10.1080/00220973.2017.1381067. Ryan RM. Psychological needs and the facilitation of integrative processes. J Pers. 1995;63(3):397–427. https://doi.org/10.1111/j.1467-6494.1995.tb00501.x. Gagné M, Deci EL. Self-determination theory and work motivation. J Organ Behav. 2005;26(4):331–62. https://doi.org/10.1002/job.322. Tollafield D. When did podiatrists first use local anaesthetic?: Consulting Foot Pain; 2021 [Available from: https://consultingfootpain.co.uk/when-did-podiatrists-first-use-local-anaesthetic/.