Abstract

Background Pharmacist role expansion, including pharmacist prescribing, is increasing globally. Assessing the impact of such role expansion is vital.

Purpose To identify key outcomes to evaluate pharmacist prescribing within Ireland’s planned Common Conditions Service (CCS) and independent pharmacist prescribing contexts, and determine their measurability using existing health data sources.

Methods In a three-round Delphi study, an expert panel (including pharmacists, pharmacy technicians, prescribers, public/patient contributors, policymakers, academics) rated the importance of outcomes, pre-identified via a rapid overview of reviews, using Likert scales. The research team involved public/patient team members throughout the study. Outcomes reaching consensus for inclusion (rated by ≥75% as critically important) or exclusion (<25%) after the second round were not re-rated. In the third round, remaining outcomes were re-rated and experts also rated the feasibility of measuring each outcome using existing health data sources.

Results Thirty experts completed all rounds. For CCS, seven outcomes reached consensus as critically important: Patient experience and satisfaction, Access to care, Guideline concordance, Symptom improvement, or clinical cure, Re-consultation with other health care providers, Cost of care to the healthcare system, and Referral to other healthcare providers. For other independent prescribing contexts, ten outcomes were critically important, including Mortality, Clinical effectiveness, Adverse events, and Cost of care to patients. Important CCS outcomes varied in their measurability using existing data, with Prescribing rate (76% agreement) and Cost to patients (64% agreement) were most feasible.

Conclusions This study identified priority outcomes for evaluating the impact of pharmacist prescribing, encompassing clinical, safety, economic, and patient perspectives.

Highlights

Clinical, economic, safety, and patient-reported outcomes are key for assessing the impact of pharmacist prescribing.

Seven priority outcomes were identified for Common Conditions Services, and ten for wider independent prescribing contexts.

Existing health data can support outcome measurement, but enhancements are needed to improve interoperability and coverage.

Pharmacist prescribingOutcome identificationCommon conditionDelphi methodConsensus methodspublicpatient involvementCompeting Interest Statement

JS was a Member of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland. CMC was a Member of the Research Sub-Committee of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland. Other authors have no interests to declare

Funding Statement

This research was funded by the Department of Health.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was granted by the RCSI University of Medicine and Health Sciences Research Ethics Committee (REC) (reference number REC202411038)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Footnotes

Declaration of interests JS was a Member of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland. CMC was a Member of the Research Sub-Committee of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland. Other authors have no interests to declare.

Funding This research was funded by the Department of Health.

Data Availability

All relevant study data are available in the manuscript and supplementary files