Abstract：
In some countries, pharmacists have obtained prescribing rights to improve quality and accessibility of care and reduce physician workload. This case study explored pharmacists\' current roles in and potential for prescribing in primary care in the Netherlands, where prescribing rights for pharmacists do not exist. Participatory observations of pharmacists working in either general practice or community pharmacy were conducted, as were semi-structured interviews about current and potential practice. The latter were extended to patients and other healthcare professionals, mainly general practitioners, resulting in 34 interviews in total. Thematic analyses revealed that pharmacists, in all cases, wrote prescriptions that were then authorized by a physician before dispensing. General practice-based pharmacists often prescribed medications during patient consultations. Community pharmacists mainly influenced prescribing through (a) medication reviews where the physician and/or practice nurse often were consulted to make treatment decisions, and (b) collaborative agreements with physicians to start or substitute medications in specific situations. These findings imply that the pharmacists\' current roles in prescribing in the Netherlands resemble collaborative prescribing practices in other countries. We also identified several issues that should be addressed before formally introducing pharmacist prescribing, such as definitions of tasks and responsibilities and prescribing-specific training for pharmacists.
摘要：
在一些国家,药剂师已经获得了处方权利，以提高护理质量和可及性，并减少医生的工作量。本案例研究探讨了药剂师在荷兰初级保健中的当前角色和潜在处方，不存在药剂师的处方权。对在普通实践或社区药房工作的药剂师进行了参与性观察，以及关于当前和潜在实践的半结构化访谈。后者扩展到患者和其他医疗保健专业人员，主要是全科医生，总共进行了34次面试。主题分析表明，药剂师，在所有情况下,写处方，然后在配药前由医生授权。基于一般实践的药剂师经常在患者咨询期间开处方。社区药剂师主要通过（a）药物审查来影响处方，其中医生和/或执业护士经常被咨询以做出治疗决定，（b）与医生达成合作协议，以在特定情况下开始或替代药物。这些发现表明，药剂师目前在荷兰处方中的作用类似于其他国家的协作处方实践。我们还确定了在正式介绍药剂师处方之前应该解决的几个问题，例如任务和责任的定义以及针对药剂师的处方特定培训。
