Developing quality of care indicators for community-based pharmacist prescribing of ambulatory conditions and contraception in British Columbia, Canada

Background: Community-based pharmacists can prescribe for ambulatory conditions and contraception in many jurisdictions. Evidence that describes the measures of a high-quality prescribing service delivered by pharmacists is lacking. Methods: We sought to develop measures that could inform potential quality indicators to evaluate pharmacists’ prescribing in the community setting in British Columbia. This study used a qualitative methodology comprising 1:1 semi-structured interviews with patients, pharmacists, physicians/nurse practitioners, and leaders from stakeholder organizations to identify measures of a high-quality prescribing service delivered by pharmacists. Data analysis was completed using reflexive thematic analysis. A constructive workshop with a sample of participants was conducted to validate and prioritize the quality measures and determine implementation feasibility. Results: Sixty-four interviews were analyzed (16 patients, 12 pharmacists, 23 physicians/nurse practitioners, and 13 stakeholder organization leaders). Thirty-three measures were proposed, aligning with 5 major themes: patient experience, efficacy, safety, access, and cost-effectiveness. Patients emphasized the importance of privacy and the use of appropriate pronouns within the theme of patient experience, while physicians/nurse practitioners focused on clinical efficacy, suggesting that adhering to documentation standards and interdisciplinary communication are the top measures of quality. All interviewee groups agreed that access-based quality indicators, such as wait times and geographical distribution, are important to develop. Cost-effectiveness, a unique theme not typically linked to quality, emerged as a key measure. Discussion and conclusion: This study identified 33 possible measures that can be used to develop quality indicators for pharmacists prescribing in community-based practice settings to evaluate such programs.