Dutch General Practitioners' Views on Pharmacist Prescribing: A Nationwide Survey

Abstract

Background: Pharmacists in the Netherlands currently lack prescribing authority, despite evidence from other countries indicating positive outcomes in healthcare quality, satisfaction and accessibility. While previous research has explored the views of patients and pharmacists, the view of general practitioners (GPs) remains unexplored. Aim: This study investigated Dutch GPs’ views on pharmacist prescribing in primary care. Method: A nationwide online cross-sectional survey was conducted among Dutch GPs between October and December 2024. The survey was distributed through professional networks and social media platforms. The questionnaire included ten scenarios involving prescribing by pharmacists. In this study, ‘more complex cases’ referred to situations requiring multifaceted clinical judgement (e.g. switching antidepressants due to ineffectiveness), whereas ‘less complex cases’ involved straightforward medication management (e.g. repeat prescriptions or adjusting dosages under stable conditions). Each participant was randomly assigned to respond to six of these scenarios. Additional questions involved preconditions, benefits and risks associated with pharmacist prescribing. Responses were measured using a 4-point Likert scale. Data were analyzed using descriptive analysis. Results: In total, 347 participants were included, 60.2% (n=209) of whom were female and 72.69% (n=253) worked as independent GP. The majority (95.4%; n=331) (somewhat) agreed with at least one scenario of pharmacist prescribing, whereas 16 participants (4.6%) (somewhat) disagreed with all scenarios. Participants were generally supportive of pharmacist prescribing in “less complex cases”, for example repeat prescriptions (81.5%; n=167/205) and therapeutic substitution due to drug shortages (87.7%; n=186/212). However, more complex cases, such as switching antidepressants due to ineffectiveness received less support (24.6%; n=51/207). The most frequently agreed-upon preconditions were acceptance by medical associations and feedback to GPs when pharmacists prescribe (both 91.9%; n=319). Improved collaboration between GPs and pharmacists (63.7%, n=221) and reduced workload for GPs (60.2%, n=209) were noted as potential benefits, whereas increased workload for pharmacists (86.4%, n=294) was the most commonly identified risk. Conclusion: The majority of Dutch GPs who participated in this study perceive opportunities for pharmacist prescribing in primary care, particularly for managing less complex patient cases. However, more complex cases, such as switching antidepressants due to ineffectiveness, received less support, potentially due to key preconditions for implementation that have yet to be met.