Prostate cancer consultations are common in primary care and there is no one approach to testing and treatment that fits all patients. Urologist Simon van Rij discusses the key considerations and options for personalised care, appropriate investigation and treatment
Non-medical prescribers effective in management of chronic disease
Vault Navigation
Non-medical prescribers effective in management of chronic disease
Compared with medical prescribers (usual care), how effective are non-medical prescribers for managing acute and chronic health conditions in primary and secondary care settings?
Non-medical prescribers practising in a variety of settings, and with varying but high levels of prescribing autonomy, achieved comparable outcomes in the management of chronic disease and preventive healthcare. Non-medical prescribers delivered comparable outcomes to medical prescribers for systolic blood pressure, glycated haemoglobin, low-density lipoprotein, medication adherence, patient satisfaction and general quality of life. Pharmacists and nurses were able to deliver comparable prescribing outcomes with varying levels of undergraduate, postgraduate and specific on-the-job training. Non-medical prescribers frequently have medical support available to facilitate a collaborative practice model. Non-medical prescribers across a range of different settings in low, medium and high-income countries may be able to assist in meeting the growing burden of chronic disease, or where doctor shortages or scarce health resources exist.
The uncertainty of evidence in studies reporting adverse events and resource use made it difficult to determine the impact of non-medical prescribers compared with medical prescribers for these outcome measures.
A range of health workforce strategies are needed to address health service demands in low, middle and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals and physician assistants complementing or substituting for doctors in a prescribing role. This is one approach to improve access to medicines.
Weeks G et al. Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Reviews, 2016, Issue 11. Art. No.: CD011227.DOI: 10.1002/14651858. CD011227.pub2. This review contains 46 studies involving 37,337 participants.