title: Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study.
abstract: Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients' access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders' views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders' perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients' access to medicines, reduce doctors' workload and promote the utilisation of pharmacists' skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists' inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all stakeholders acknowledged the potential of pharmacist prescribing to increase patients' access to medicines in Nigeria.
authors.affiliation: School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK. aauta@uclan.ac.uk.
authors.forename: Asa
authors.initials: A
authors.lastname: Auta
authors.affiliation: School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK.|Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK.
authors.forename: Barry
authors.initials: B
authors.lastname: Strickland-Hodge
authors.affiliation: School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Maz
mesh_terms: D001291:Attitude of Health Personnel; D011307:Drug Prescriptions; D006297:Health Services Accessibility; D006801:Humans; D009549:Nigeria; D057240:Patient Preference; D010595:Pharmacists; D024382:Professional Role; D036301:Qualitative Research
keywords: Access to medicines; Nigeria; Patient representatives; Pharmacist prescribing; Pharmacists; Physicians; Policymakers