The Guardian reports on concerns about nurse prescribing, although any concerns may extend to other non-medical prescribers, and the editor of Pulse magazine is stated as saying:
“The whole nurse prescribing scheme has been rushed through with only the bare minimum of piloting and evaluation, and it won’t be until academics start analysing the rates of adverse events and prescribing errors that we will know whether it has been a good or bad thing,”
There are two points to be made about this:
1. The evidence for the safety of non-medical prescribing at present is extremely patchy. Extension of prescribing in the UK has been driven up to this point by NHS service requirements (it fits both with “modernisation” and patient “convenience”) and by professional healthcare professional lobbies jockeying for position and status within a changing healthcare environment, in which responsibility for the management of long-term chronic disease has been viewed as a prize. New drugs are subject to a licensing process and to NICE appraisal (in England). It is arguable that major changes in professional practice relating to prescribing should be subject to an evidence-based appraisal in a similar manner to that applied to the drugs themselves. Drugs are only as safe as the people using them.
2. The analysis of prescribing errors is notoriously difficult to undertake. Academic analysis of the nature that the editor of Pulse is asking for might be some time in coming. Comparisons of studies undertaken with different professional groups is hard given differences in study methodology, design, the clinical environment the prescribers work in, and the drugs they work with. A well-designed comparative study to examine error rates between different professional groups working in similar environments would be complex and expensive, but perhaps more reliable.
On point two, any grant to perform research on this crucially important issue of safe prescribing would be gratefully received.