A modified-Delphi study of a framework to support the potential implementation of pharmacist prescribing.

Background: There is an extensive evidence base of the effectiveness and safety of pharmacist prescribing around the globe. There is therefore potential to develop a framework to support the implementation in Qatar to achieve the National Vision 2030 of establishing a comprehensive world-class healthcare system by better utilisation of its healthcare workforce. Aim: To determine the levels of agreement amongst key stakeholders regarding a framework for the potential development and implementation of pharmacist prescribing in Qatar. Method: A quantitative, consensus-based modified Delphi study involving stakeholders in Qatar with key strategic positions of health policy influence (directors of medicine/nursing/pharmacy, lead administrators, health-related academics, patient safety leads, professional regulators) was conducted. Delphi statements were developed from extensive literature reviews, semi-structured interviews, pharmacist prescribing frameworks implemented in other countries, and based on the Consolidated Framework for Implementation Research. The scope of the statements included definitions and scope of prescribing, education and training, and governance, were validated with eight specialists from UK and Qatar, and presented as an online Delphi. Consensus was set at 70% or higher agreement and less than 15% disagreement for each statement. Results: Thirty-three experts agreed to participate in the Delphi, with a response rate of 94% for Round 1 and 91% for Round 2, at which point the Delphi stopped. Consensus was achieved for 38 out of 47 statements indicating that a collaborative prescribing model was preferred, and that experience and additional training were required along with robust governance. Consensus was not reached in relation to independent prescribing, prescribing controlled drugs, and ordering certain diagnostic/monitoring investigations (e.g. ECG, X-ray). Conclusion: High levels of agreement were attained for statements, which can constitute a framework for the development and implementation of pharmacist prescribing in Qatar. Further work is required to translate this framework into healthcare policy and practice