Exploring non-medical prescribing for patients with mental illness: a scoping review.

IF 3.4 2区 医学 Q2 PSYCHIATRY
Bashayr A Alsaeed, Jason Hall, Richard N Keers
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引用次数: 0

Abstract

Background: Non-medical prescribing (NMP) qualifications extend prescribing authority to nurses, pharmacists, and other allied health professionals and are advocated as a means to help improve healthcare efficiency and access to services. However, despite non-medical prescribers (NMPs) being utilised in some countries for more than two decades, less is known about their role and impact in the mental health context. This scoping review therefore aims to map published research evidence concerning NMP for patients with mental illness.

Methods: Five electronic databases were searched from January 2003 to July 2024. Reference lists of identified papers were also checked for relevant studies. Full text primary research studies exploring the nature, impact, and implementation of NMP services for patients with mental illness and dementia in community settings were included.

Results: From 22,547 retrieved papers, 63 studies were included. Of these, 57 (90.4%) detailed the nature (including the service or team they were based in, medicines prescribed, and main role(s)) of NMPs, 45 (71.4%) assessed the impact of services, and 16 (25.3%) explored factors influencing service implementation and delivery. The majority of studies originated from the USA (30/63, 47.6%), or the United Kingdom (27/63, 42.8%). Either nurse (44/63, 69.8%), pharmacist (16/63, 25.3%) or non-medical prescribing models featuring both professionals were exclusively studied (3/63, 4.7%). In the UK and USA, antidepressants (60%, 54.5%) were the most prescribed by NMPs. Although the conditions of patients managed by both nurse and pharmacist prescribers were reported to be well managed based on clinical outcomes (3/24, 12.5% and 3/13, 23%, respectively), few studies evaluated health outcomes. Training-related barriers to service delivery were commonly mentioned in UK studies (4/9, 44.4%), with financial issues reported in the USA (2/4, 50%).

Conclusions: This review highlights the diverse roles of NMPs in the care of people with mental illness. Whilst the limited evidence suggests a positive impact on patient care, more quantitative research is needed. Given the focus on nursing prescriber models in this review, along with rising mental health demand and continuing staff shortages, future research should prioritise exploring and evaluating the contribution of pharmacist NMP services as well other healthcare professionals' NMPs.

探索精神疾病患者的非医学处方:范围审查。
背景:非医疗处方(NMP)资格将处方权限扩展到护士、药剂师和其他专职卫生专业人员,并被提倡作为一种帮助提高医疗效率和获得服务的手段。然而,尽管非医疗处方(nmp)在一些国家使用了20多年,但人们对其在精神卫生方面的作用和影响知之甚少。因此,本综述的目的是绘制关于精神疾病患者NMP的已发表的研究证据。方法:检索2003年1月~ 2024年7月5个电子数据库。还检查了已确定论文的参考文献列表,以查找相关研究。全文主要研究探索的性质,影响和实施NMP服务的精神疾病和痴呆症患者在社区设置包括。结果:从22,547篇检索论文中,纳入63项研究。其中,57份(90.4%)详细说明了nmp的性质(包括他们所在的服务或团队、处方药物和主要角色),45份(71.4%)评估了服务的影响,16份(25.3%)探讨了影响服务实施和提供的因素。大多数研究来自美国(30/63,47.6%)或英国(27/63,42.8%)。仅对护士(44/ 63,69.8%)、药剂师(16/ 63,25.3%)或两种专业的非医疗处方模式进行研究(3/ 63,4.7%)。在英国和美国,抗抑郁药(60%,54.5%)是nmp开的最多的药。虽然据报道,护士和药剂师处方者管理的患者的病情根据临床结果得到了很好的管理(分别为3/ 24.12.5%和3/ 13.23%),但很少有研究评估健康结果。在英国的研究中,与培训相关的服务提供障碍被普遍提到(4/ 9,44.4%),而在美国,财务问题被报告(2/ 4,50%)。结论:本综述强调了nmp在精神疾病患者护理中的不同作用。虽然有限的证据表明对病人护理有积极影响,但需要更多的定量研究。鉴于本综述对护理处方模型的关注,以及不断增长的心理健康需求和持续的人员短缺,未来的研究应优先探索和评估药剂师NMP服务以及其他医疗保健专业人员的NMP服务的贡献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Psychiatry
BMC Psychiatry 医学-精神病学
CiteScore
5.90
自引率
4.50%
发文量
716
审稿时长
3-6 weeks
期刊介绍: BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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