142 Analysis and impact of non medical prescribing interventions at John Taylor hospice

Abstract

Introduction The growth in non-medical prescribing (NMP) by nurses and pharmacists has been well documented across a range of medical specialities. Prescribing by allied health professionals in palliative care is a relatively recent phenomenon. Outcome data for community palliative care prescribing is poorly characterised, and evidence of impact remains unsubstantiated. The purpose of this study was to gauge self-reported outcomes of prescribing interventions by nurse and pharmacist prescribers for patients in a community setting. Methods Prescribing data was collected between 1st May and 1st July 2019. Data included perceived reasons for prescription issue and the outcome of the intervention. Data was anonymised and analysed using MS Excel to quantify the classes of drugs prescribed, and identify prescribing patterns. A second phase involved an online survey of medical and NMPs at the hospice to explore their views on independent prescribing. Results Data from 7 nurse and 2 pharmacist NMPs were analysed. In over one third (35%) of prescribing events, prescriptions were for routine symptom control such as pain or nausea. Provision of anticipatory injectable medicines was the second most common reason for prescription issue. Forty eight percent of patients prescribed medicines for symptom control achieved faster access to treatment. In 57% of prescription events a GP home visit was prevented. Analysis of the surveys is pending and themes arising from these will be shared amongst the hospice prescribing team. Conclusion As a result of non-medical prescribing, patients receiving community palliative care were able to access crucial medicines in a timely manner which may have facilitated better symptom control. The study’s main limitation was that prescribers completed data collection forms themselves, which may have influenced their choice of outcome. Potential savings of approximately £2,595 in GP visits suggest that utilisation of NMP prescribing should be more widely considered in palliative care teams.