Prescribed Only Medications (POMs) issued in a musculoskeletal physiotherapy primary care

Purpose

Non-medical prescribing was introduced in the United Kingdom (UK) to improve healthcare service efficiency, access to medicines and support service innovation. From 2013, independent prescribing was extended to include physiotherapists. Patients are facing increasingly long waiting times to see their GPs, and delays getting medication to aid their musculoskeletal ailments. This report aims to explore patient satisfaction of this service in a primary care musculoskeletal physiotherapy setting. IPOPS started provision of independent prescribing during physiotherapy sessions by a single physiotherapy practitioner in March 2017.

Approach

Patients who were given prescriptions (FP10) during their physiotherapy session from a 12-month period by a single physiotherapy independent prescriber (March 2017 to March 2018) were given a 6-part satisfaction questionnaire. A numeric scale rating from 1 to 10 (1 - least satisfied to 10 - most satisfied) was used for questions 1 to 4. Questions 5 and 6 were responded with patient comments regarding the service. 1. How satisfied are you with being provided with a prescription today? 2. How satisfied are you with combined care of physiotherapy and a prescription? 3. How satisfied are you with the timing of your prescription. 4. How satisfied are you with the education received regarding your prescription today? 5. Comparing this experience of receiving your prescription from a physiotherapist how would you rate your experience compared to being provided with a prescription by your GP or nurse practitioner? 6. Is there anything you feel could be improved?

Outcomes

106 prescriptions were issued during that period. These included: naproxen (16) 15%, gabapentin (14) 13%, amitriptyline (13) 12%, pregabalin (11) 10%, ibuprofen gel 10% (9) 8%, omeprazole (9) 8%, , capsaicin cream (8) 8%, diazepam (8) 8%, vitamin D (7) 7%, lanzoprazole (6) 6% and alendronic acid (5) 5%.

The mean satisfaction ratings were as follows: Question1 - 9/10 rating, Question 2 - 10/0 rating, Question 3 - 8/10, Question 4 - 10/10 rating. For questions 6 and 7, the responses were all positive and included comments such as “quicker service”, “it was good I received my prescription by the clinician diagnosing and managing my problem”, “excellent service”, “shame that not all physios can prescribe”.

Implications

Although the sample size was relatively small, all the patients rated the service highly with positive comments. The experience they had was comparable to that by a General Practitioner (GP) or Nurse Practitioner.

All patients were happy to receive physiotherapy treatment and prescriptions if required creating the concept of a 'one stop shop' and reducing time that would have been needed to book an appointment with a GP to get a similar prescription. The independent prescribing role can be extended to reviewing medication and weaning advice as symptoms improve.

Fund acknowledgements

This work was not funded.

Additional notes

This work was presented at Physiotherapy UK 2018.