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Patients nervous over nurse scripts

A substantial proportion of patients have misgivings about being prescribed medicines by nurses or pharmacists, a survey of their views has revealed.

The findings have prompted warnings that resistance to non-medical prescribing from patients could present a 'major problem' to Government plans.A second study suggested elderly patients in particular might be resistant to taking advice from health professionals who had not been trained as doctors.There are concerns that any efficiency savings in using nurses or pharmacists could be eroded if patients insisted on subsequently seeing a doctor.In the survey of 400 patients, as many as 40 per cent were not confident in nurses and pharmacists prescribing to them independently, even when they had received specialist training.This figure rose to 85 per cent when patients were asked whether nurses or pharmacists were safe to prescribe without receiving specialised training – although it was unclear how much training patients regarded as being sufficient.The survey was published online by Eye and details the opinions of patients visiting hospital ophthalmology departments. Kashif Qureshi, a researcher at St George's Hospital NHS Trust in London who conducted the survey, said: 'A significant proportion of patients are not confident that nurses or pharmacists, even with specialist training, can prescribe their medication. 'This constitutes a major problem as the authority of specialist nurses or pharm-acists will undoubtedly be in question.'Reasons for a lack of confidence included a perception non-medical prescribers lacked appropriate training and were not sufficiently supervised.In the second study, published online by the BMJ, researchers reported that pharmacists' advice was often 'actively resisted' by patients aged over 80, who wanted recourse to GPs or hospital doctors instead.Chris Locke, chief executive of Nottingham LMC, said the research bore out expectations that 'patients aren't happy to be seen by nurses for certain things'.He added: 'There's a comparable situation with walk-in centres – a concern that for anything complicated the patient may go back to the GP.'But Dr Charlie Daniels, chair of Devon LMC, said patients had not objected when seeing the nurse prescriber in his surgery. 'There will be a slow, gradual acceptance of it,' he said.

Patients' reservations

• Nurses and pharmacists insufficiently trained• Supervision of non-medical prescribing may be inadequate• Nurses and pharmacists less likely than doctors to be familiar with patient

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