Assoc Prof Sarah Dineen-Griffin

Background: There has been a growing interest in granting prescribing rights to pharmacists as a strategy to improve healthcare access. Researchers continue to explore the impact and implementation of pharmacist prescribing. Given the recent international changes in this field, an overview of current territories allowing pharmacist independent prescribing would provide a comprehensive understanding for researchers and policymakers. Aim: This scoping review aims to summarize the countries and specific jurisdictions where pharmacists can prescribe independently in community pharmacy, and map the conditions they can prescribe for, required training, and reimbursement policies. Method: This scoping review was conducted in October 2024 and has been reported following the PRISMA-ScR guidelines. Searches were performed in Scopus, Web of Science, CINAHL, PubMed, and Cochrane databases, along with grey literature searches using Google. Results: A total of 88 studies and reports were identified. The countries where pharmacist can prescribe independently include the United Kingdom, the United States, Canada, Australia, Poland, Switzerland, and Denmark. Pharmacists authorized as independent prescribers generally require post-registration training and are authorized to initiate, adapt, renew, or substitute prescriptions. For the payment and reimbursement, this service is publicly funded only in Canada, Denmark, France, and the United Kingdom. Conclusion: Pharmacist prescribing practices vary significantly worldwide, with differences in terminology, legislation, and training requirements. This scoping review provides the necessary information to visualize and conceptualize the current scope of pharmacist independent prescribers, offering a foundation for advancing this practice in new jurisdictions. Further research should address current models in under-studied regions, explore the scope for pharmacists to prescribe for undiagnosed conditions, and analyze payment structures in non-funded jurisdictions.

Scholarly publishing is in a crisis, with the many stakeholders complaining about different aspects of the system. Authors want fast publication times, high visibility and publications in high-impact journals. Readers want freely accessible, high-quality articles. Peer reviewers want recognition for the work they perform to ensure the quality of the published articles. However, authors, peer reviewers, and readers are three different roles played by the same group of individuals, the users of the scholarly publishing system¿and this system could work based on a collaborative publishing principle where "nobody pays, and nobody gets paid".

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government's Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. It appears that community pharmacy is not sufficiently represented at a local level. Current service remuneration models encourage a volume approach. While more complex services and clinical roles, with associated remuneration structures (such as, accredited pharmacists, pharmacists embedded in general practice and residential aged care facilities) promote follow up, collaboration and integration into primary health care, they potentially marginalize community pharmacies. Community pharmacists' roles have evolved and are being recognized as the medication management experts of the health care team at a less complex level with the delivery of MedChecks, clinical interventions and medication adherence services. More recently, vaccination services have greatly expanded through community pharmacy. Policy documents from professional bodies highlight the need to extend pharmacy services and enhance integration within primary care. The Pharmaceutical Society of Australia's Pharmacists in 2023 report envisages pharmacists practising to full scope, driving greater efficiencies in the health system. The Pharmacy Guild of Australia's future vision identifies community pharmacy as health hubs facilitating the provision of cost-effective and integrated health care services to patients. In 2019, the Australian Government announced the development of a Primary Health Care 10-Year Plan which will guide resource allocation for primary health care in Australia. At the same time, the Government has committed to conclude negotiations on the 7th Community Pharmacy Agreement (7CPA) with a focus on allowing pharmacists to practice to full scope and pledges to strengthen the role of primary care by better supporting pharmacists as primary health care providers. The 7CPA and the Government's 10-year plan will largely shape the practice and viability of community pharmacy. It is essential that both provide a philosophical direction and prioritize integration, remuneration and resources which recognize the professional contribution and competencies of community pharmacy and community pharmacists, the financial implications of service roles and the retention of medicines-supply roles.