Abstract
Background: An expanding body of literature shows that pharmacists’ interventions improve health outcomes and are cost-saving. However, diverse state regulations of pharmacists’ scope of practice create a discrepancy between what pharmacists are trained to do and what they legally can do. This study hopes to investigate stakeholder utilization of research evidence to expand scope of practice in their respective states.Methods: Using autonomous pharmacist prescriptive authority as a surrogate for general pharmacist scope of practice, a general policy document analysis was performed to understand the scope of practice landscape for pharmacists across the United States. Next, a systemized review and semi-structured interviews were conducted to explore how the identified states in the policy document analysis utilized evidence during the policy make process. Investigators analyzed findings from the systemize review and transcribed interviews through application of the SPIRIT Action Framework. Resulting codes were summarized across themes, and recommendations to researchers about increasing utilization of research evidence were crafted. Results: Sixteen states with 27 autonomous pharmacist prescriptive authority policies were identified. The systemized review yielded no relevant peer-review literature regarding evidence utilization, so gray literature and interviews were analyzed. Public health need and safety considerations motivated evidence engagement, while key considerations dictating utilization of research included perceptions of research, access to resources and experts, and the successful implementation of similar policy. Research evidence helped to advocate for and set terms for pharmacist prescribing. Barriers to research utilization include stakeholder opposition to pharmacist prescribing, inability to interpret research, and a lack of relevant evidence. Recommendations for researchers include investigating specific metrics to evaluate scope of practice policy, developing relationships between policymakers and researchers, and leveraging pharmacy practice stakeholders.Conclusions: Overall, alignment of researcher goals and legislative priorities, coupled with timely communication, may help to increase research evidence engagement in pharmacist scope of practice policy. By addressing these factors regarding research engagement identified in this study, researchers can increase evidence-based scope of practice, which can help to improve patient outcomes, contain costs, and provide pharmacists with the legal infrastructure to practice at the top of their license.
Pre-hospital policies for the care of patients with acute coronary syndromes in India: A policy document analysis
