Competencies needed for pharmacist prescribing: A qualitative study of competency frameworks to identify gaps in Dutch pharmacy education

Abstract

Introduction: Countries exploring potential non-medical prescribing by pharmacists, such as the Netherlands, face uncertainty about the additional competencies required. This study aimed to identify prescribing-related competency gaps in Dutch pharmacy competency frameworks to support the preparation of pharmacists for prescribing roles. Methods: A qualitative content analysis compared competency frameworks for pharmacist prescribers in New Zealand and the United Kingdom with Dutch under- and postgraduate pharmacy education frameworks. Learning objectives were aligned to identify gaps. Semi-structured interviews with educational experts from Dutch pharmacy programs further explored required competencies. Interviews were audio-recorded, transcribed, and thematically analyzed. Results: Twelve competencies that pharmacists should acquire or expand were initially identified through the content analysis and discussed with the experts in five interviews. Expert input indicated that Dutch pharmacists need to acquire or expand seven competencies, particularly those related to physical examinations and laboratory testing, assuming responsibility for prescribed treatments, monitoring and follow-up, and managing potential conflicts of interest. Making diagnoses was not considered necessary, as a diagnostic role was not foreseen, unlike in the United Kingdom. Other initially identified competencies were already addressed in Dutch pharmacy education. Experts favoured a collaborative prescribing model, similar to New Zealand's, and noted challenges for curriculum revision. Conclusion: Preparing pharmacists for prescribing roles in the Netherlands requires integrating several new or expanded competencies into pharmacy education. Regardless of the prescribing model to be introduced, assuming responsibility for prescribing decisions and outcomes appears essential.