Evaluation of physiotherapy, podiatrist independent prescribing, mixing of medicine and prescribing of controlled drugs

Start date

01 July 2016

End date

31 August 2016

Aim

The aim is to evaluate the effectiveness and efficiency of independent prescribing by physiotherapists and podiatrists (PPs). The study will compare services provided by physiotherapists and podiatrists who are qualified to independently prescribe to those provided by physiotherapists and podiatrists who are not qualified to prescribe. This will help determine whether there are any differences in the quality of care or cost of services. We will ask PPs their views, what training they have had, what makes their job difficult and seek views of other professionals working in the same setting. Patients will also be asked what they think. 

Plan of investigation

This study will be conducted in three phases. Phase 1 will comprise of a literature review, to understand the different ways that physiotherapists and podiatrists use prescribing in practice. Phase 2 will be an analysis of key documents and survey of trainee PP independent prescribers. The survey will explore how and where physiotherapist and podiatrist independent prescribing is being put into action.  Phase 3 will comprise a comparative case study of 6 sites where physiotherapists or podiatrists use independent prescribing and 6 non-prescribing PP sites. Case studies will be from different hospital or community based clinics around England.

 

Progress

Phase one

Integrative literature review has been completed and currently under review for publication.

Phase two

Data collection for the longitudinal online-survey, exploring trainee PP-IPs views and experiences regarding implementation of PP-IP, and educational preparation for training is now complete. The survey had two data-collection points; enrolment and end of IP course and closed at the end of March 2016. 85 people responded to the first questionnaire, and 40 people responded to questionnaire 2.

 Information was collected on:

  • Intended practice areas
  • Service provision and care organisation
  • Organisational preparedness
  • Barriers/facilitators for PP-IP
  • Educational preparation.

Documentary evidence - Case study sites were asked to provide relevant documents relating to service specification, organisational support and resources. Data collection closed for this phase of the project at the end of April 2016.

Phase three

Fourteen case sites were recruited to the project from Berkshire, Dorset, Sussex, Surrey, South London, Kent, Hampshire, Middlesex and Lancashire and County Durham. The roles of the practitioners collaborating in the study varied widely, including community physiotherapists, diabetic podiatrists and those operating in private practice. Data collection at all 14 sites (6 podiatrists and 8 physiotherapists) is now complete. 488 participants were recruited, out of which 314 completed questionnaires (67.1% response rate), and 195 subsequently completed the telephone/email follow-up questionnaire (68.4% response rate).

Funder

Team

University of Surrey researchers

Heather Gage profile image

Professor Heather Gage

Professor of Health Economics

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Peter Williams

Statistics Consultant

Collaborators

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Dr Jane Brown

Liverpool John Moores University

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Professor Molly Courtenay

Cardiff University

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Professor Ann Moore

University of Brighton

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Dr Simon Otter

University of Brighton

Outputs

Research dissemination

A project dissemination event was held in London in July 2017. 

presentation slides.

Study findings have also been presented at:

  • Association for Prescribers Annual Conference, London, 9 November 2017
  • 8th Non-Medical Prescribing Conference, Weston Super-Mare, 27 June 2017
  • Allied Health Professions Medicines Mechanisms Seminar, AHP Medicines Project, NHS England, The Place Aparthotel, Manchester, 23 February 2017
  • College of Podiatry Conference 2016, SEC, Glasgow, 17-19 November 2016
  • IFOMPT (International Federation of Manipulative Physiotherapists) Conference 2016, SEC, Glasgow, 4-8 July 2016.

Research team articles

Carey N, Stenner K, Courtenay M. (2014) 'An exploration of how nurse prescribing is being used for patients with respiratory conditions across the east of England.'. BMC Health Serv Res, England: 14 (1)
doi: 10.1186/1472-6963-14-27

Carey N, Courtenay M, Stenner K. (2013) 'The prescribing practices of nurses who care for patients with skin conditions: a questionnaire survey.'. Wiley J Clin Nurs, England: 22 (13-14), pp. 2064-2076.
doi: 10.1111/jocn.12271

Stenner K, Carey N, Courtenay M. (2012) 'Prescribing for pain - how do nurses contribute? A national questionnaire survey'. Journal of Clinical Nursing, 21 (23-24), pp. 3335-3345.
doi: 10.1111/j.1365-2702.2012.04136.x

Stenner K, Carey N, Courtenay M. (2012) 'Prescribing for pain - how do nurses contribute? A national questionnaire survey.'. J Clin Nurs,
doi: 10.1111/j.1365-2702.2012.04136.x

Courtenay M, Carey N, Stenner K. (2012) 'An overiew of non medical prescribing across one strategic health authority: a questionnaire survey.'. BMC Health Serv Res, England: 12
doi: 10.1186/1472-6963-12-138

Read the full text. Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA.

Carey N, Stenner K. (2011) 'Does non-medical prescribing make a difference to patients?'. Nurs Times, England: 107 (26), pp. 14-16.

Stenner KL, Courtenay M, Carey N. (2011) 'Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views'. Elsevier International Journal of Nursing Studies, 48 (1), pp. 37-46. doi:10.1016/j.ijnurstu.2010.06.006. Read the full text.

Research information sheets

Project reports