DEPARTMENT OF PHARM
ACY
UNIVERSI
TY OF MA
LTA
PHARMACIST PRESCRIBING FRAMEWORK FOR OPHTHALMIC AND SKIN CONDITIONS
Gianella Casha, Lilian M. Azzopardi, Anthony Serracino-Inglott
Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
email: gianella.casha.10@um.edu.mt
INTRODUCTION
Over the past years the pharmacy profession has been shifting from a
product based approach to a patient focused practice and pharmacist
prescribing is one of the implementations being enforced to improve
the pharmacy-patient outcome. Eight pharmacist prescribing systems
are being put into practice among different countries, including: UK,
New Zealand, US, and Canada. From a local study in 2013, it emerged
that 37 out of 45 were in favour of Supplementary Prescribing by
1
collaborating with GPs for minor infections and skin conditions .
Department of Pharmacy
University of Malta
AIMS



To develop a set of guidelines for minor eye
infections and skin conditions to propose a
framework for prescribing by pharmacists.
To develop a documentation strategy and a
monitoring system.
To validate and evaluate the guidelines so as
to establish the practicality, presentation and
comprehensiveness
METHOD
Phase 1
 An intensive literature review was carried out to obtain knowledge on the aetiology, symptoms and treatment options for eye
infection (including bacterial conjunctivitis, chalazion and hordeolum) and skin conditions (including psoriasis, acne and insect
bites).
 A set of guidelines were set out to help pharmacists in their diagnoses, treatment selection, documentation and communication
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with other healthcare professionals. These guidelines include a set of protocols based on studies by Darmanin (2010) and
3
Stivala (2012) describing the symptoms, areas for referral and treatment options. A prescription template, a referral form and
a repeat prescription template were also set up.
 The guidelines were validated by a group of health care professionals and amendments were carried out based on their
suggestions.
Phase 2
 A validated questionnaire was distributed together with the guidelines to 15 local community pharmacists for 2 weeks.
 A set of questions were set up and 15 local GPs were visited to assess their feedback on pharmacist prescribing for the studied
conditions using the proposed framework
RESULTS
 The pharmacists that completed the questionnaire agreed that the documents compiled were understandable, easy to follow,
helpful and practical for their intended use, are of appropriate length and contain the right technical terms and amount of
information.
 When pharmacists were asked to mention other ophthalmic and skin conditions which they would like to prescribe in; eczema,
fungal infections, superficial mycosis of the nail and ophthalmic seasonal allergies were amongst the conditions mentioned.
 All of the pharmacists agreed that the implementation of pharmacist prescribing could be a step forward in the management of
overuse, misuse and antibacterial resistance.
 6 out of 15 GPs disagree with pharmacist prescribing mainly because they believe pharmacists are not trained to diagnose and
such implementation can be a target for conflict of interest.
 7 GPs were concerned that such implementation could create a competition among different healthcare professionals such as GPs
and pharmacists and nurses and pharmacists.
 All pharmacists and GPs agreed that patient medication records should be available to all healthcare professionals who take the
responsibility to prescribe.
CONCLUSION
Compared to earlier studies it was concluded that medical practitioners are improving their idea on pharmacist prescribing.
However the majority of GPs interviewed still oppose the idea for different reasons, mainly because they feel that
pharmacists have expertise of medication and are qualified to give advice and monitor a patient and not to diagnose and
start up treatment.
REFERENCES
1. Tabone F, Azzopardi LM, Serracino-Inglott A. Perception of the community pharmacist: Impact services and development of pharmacist prescribing. Germany: Lap Lambert,
2013
2. Darmanin T. Validation of Protocols for Skin Conditions [Project]. Malta: Department of Pharmacy, University of Malta; 2010
3. Stivala B. Compliance with Protocols in Eye Conditions [Project]. Malta: Department of Pharmacy, University of Malta; 2012