Non-medical prescribing in chronic non-malignant pain

INTRODUCTION: Chronic non-malignant pain poses considerable risk to patients and the health service but its management is still inadequate. The introduction of prescribing for nurses and pharmacists suggests that non-medical prescribing can improve some important aspects of health care services AIM: To provide new insights and theory regarding how nurses and pharmacists prescribe for chronic pain, together with how the service is perceived by chronic pain patients and to uncover barriers and facilitators encountered when this group is prescribed for. METHOD: A mixed methods strategy was employed in this study. A grounded theory approach was used to collect data from non-medical prescribers and patients. Non- medical prescribers were then surveyed to confirm the emerging theory and determine barriers and facilitators. FINDINGS: The theory 'safety and support within the prescribing environment' explains the relationship that non-medical prescribers have with colleagues, patients and other factors in their prescribing environment in their prescribing for chronic pain. Non-medical prescribers are motivated by various factors and may adopt an innovative or conservative approach in their prescribing. Nurses were more likely to engage in informal mentoring relationships, but were limited by their lack of medication knowledge. Pharmacists were limited by a lack of experience with patients, inaccessibility to formal CPD in paid work time and the threats introduced by concerns around 'second checking'. Chronic pain patients had strategies to maintain relationships with their prescribers and this relationship influenced the likelihood of considering other measures to cope with their pain. CONCLUSION: Nurses and pharmacists who qualified as prescribers would be more likely to prescribe for chronic pain if they perceived certain essential elements in their prescribing environment. This theory can facilitate assessment of non-medical prescribers' support, involvement of patients and the development of resources to encourage prescribing.EThOS - Electronic Theses Online ServiceGBUnited Kingdo