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Characterising the growth in palliative care prescribing 2011-2015: Analysis of national medical and non-medical activity

Ziegler, Lucy
Bennett, M.I.
Mulvey, M.
Hamilton, T.
Blenkinsopp, Alison
Publication Date
2018
End of Embargo
Supervisor
Rights
(c) 2017 The Authors. Full-text reproduced in accordance with the publisher's self-archiving policy.
Peer-Reviewed
Yes
Open Access status
openAccess
Accepted for publication
2017-09-15
Institution
Department
Awarded
Embargo end date
Abstract
The role of non-medical prescribers working in palliative care has been expanding in recent years and prescribers report improvements in patient care, patient safety, better use of health professionals’ skills and more flexible team working. Despite this, there is a lack of empirical evidence to demonstrate its clinical and economic impact, limiting our understanding of the future role of non-medical prescribers within a healthcare system serving an increasing number of people with palliative care needs. We developed a unique methodology to establish the level of non-medical prescribers’ activity in palliative care across England and consider the likely overall contribution these prescribers are making at a national level in this context in relation to medical prescribing. All prescriptions for 10 core palliative care drugs prescribed by general practitioners, nurses and pharmacists in England and dispensed in the community between April 2011 and April 2015 were extracted from the Prescribing Analysis Cost Tool system. The data were broken down by prescriber and basic descriptive analysis of prescription frequencies by opioid, non-opioids and total prescriptions by year were undertaken. To evaluate the yearly growth of non-medical prescribers, the total number of prescriptions was compared by year for each prescribing group. Non-medical prescribers issued prescriptions rose by 28% per year compared to 9% in those issued by medical prescribers. Despite this, the annual growth in non-medical prescribers prescriptions was less than 1% a year in relation to total community palliative care prescribing activity in England. Impact on medical prescribing is therefore minimal.
Version
Accepted manuscript
Citation
Ziegler L, Bennett MI, Mulvey M et al (2018) Characterising the growth in palliative care prescribing 2011-2015: Analysis of national medical and non-medical activity. Palliative Medicine. 32(4): 767-774.
Link to publisher’s version
Link to published version
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Article
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