The University of Southampton
University of Southampton Institutional Repository

Are nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations

Latter, Sue, Smith, Alesha, Blenkinsopp, Alison, Nicholls, Peter G., Little, Paul and Chapman, Stephen (2012) Are nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations Journal of Health Services Research & Policy, 17, (3), pp. 149-156. (doi:10.1258/jhsrp.2012.011090). (PMID:22734082).

Record type: Article


OBJECTIVES: Legislation and health policy enabling nurses and pharmacists to prescribe a comprehensive range of medicines has been in place in the UK since 2006. Our objective was to evaluate the clinical appropriateness of prescribing by these professionals.

METHODS: A modified version of the Medication Appropriateness Index (MAI) was used by 10 medical, seven pharmacist and three nurse independent raters to evaluate a sample of 100 audio-recorded consultations in which a medicine was prescribed by a nurse or pharmacist. Raters were current prescribers with recognized experience in prescribing. Consultations were recorded in nine clinical practice settings in England.

RESULTS: Raters' analysis indicated that, in the majority of instances, nurses and pharmacists were prescribing clinically appropriately on all of the ten MAI criteria (indication, effectiveness, dosage, directions, practicality, drug-drug interaction, drug-disease interaction, duplication, duration, cost). Highest mean 'inappropriate' ratings were given for correct directions (nurses 12%; pharmacists 11%) and the cost of the drug prescribed (nurses 16% pharmacists 22%). Analysis of raters' qualitative comments identified two main themes: positive views on the overall safety and effectiveness of prescribing episodes; and potential for improvement in nurses' and pharmacists' history-taking, assessment and diagnosis skills.

CONCLUSIONS: Nurses and pharmacists are generally making clinically appropriate prescribing decisions. Decisions about the cost of drugs prescribed and assessment and diagnostic skills are areas for quality improvement.

PDF Latter_et_al_JHSRP.2012.011090.full.pdf - Other
Restricted to Repository staff only
Download (108kB)
PDF Latter_et_al_JHSRP.2012.011090_Supplementary.pdf - Author's Original
Download (124kB)

More information

e-pub ahead of print date: 25 June 2012
Published date: July 2012
Organisations: Faculty of Health Sciences


Local EPrints ID: 341029
PURE UUID: fc4f7efc-ca13-45fb-a064-bbab6b303cd9
ORCID for Sue Latter: ORCID iD

Catalogue record

Date deposited: 11 Jul 2012 09:09
Last modified: 18 Jul 2017 05:39

Export record



Author: Sue Latter ORCID iD
Author: Alesha Smith
Author: Alison Blenkinsopp
Author: Peter G. Nicholls
Author: Paul Little
Author: Stephen Chapman

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.