An evaluation of mental health clinical pharmacist independent prescribers within general practices in remote and rural Scotland

Elizabeth Buist (Corresponding Author), Rebecca McLelland, Gordon Rushworth, Derek Stewart, Kathrine Lesley Gibson Smith, Andrew MacLure, Scott Cunningham, Katie MacLure*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background A 12-month pilot was implemented in two general practices in remote and rural Scotland, with patients referred by general practitioners to specialist mental health pharmacist independent prescribers. Objective The objective was to evaluate the pilot service from the perspectives of the patients and the care team. Methods The pharmacists routinely recorded patient-specific data of all clinical issues and their actions at the time of each consultation. Further datasets comprised baseline and follow-up Patient Health Questionnaire (PHQ-9) and/or Generalised Anxiety Disorder (GAD-7) rating scales, a patient survey and interviews with members of the care team. Results Of the 75 patients, two-thirds (n = 47, 62.7%) were referred with a diagnosis of mixed depression and anxiety. There were 324 consultations (median 3, IQR 2–5, range 1–14) and 181 prescribing actions. At pilot completion, 34 patients (45.3%) had PHQ-9 and/or GAD-7 scores reduced by 50%. Patient questionnaires and staff interviews generated positive responses. Conclusion This pilot has provided evidence that specialist mental health pharmacist independent prescribers delivered quality care to patients with diagnoses of moderate to severe depression and/or anxiety. Whilst accepting study limitations, there is potential to translate the pilot model of care to sustained services throughout general practice.

Original languageEnglish
Pages (from-to)1138-1142
Number of pages5
JournalInternational Journal of Clinical Pharmacy
Early online date7 Sept 2019
Publication statusPublished - Oct 2019

Bibliographical note

Funding for the pilot service was provided by the Scottish Government’s Primary Care Transformation Fund. Funding for the evaluation was provided by the Highland Pharmacy Education and Research Centre.


  • anxiety disorders
  • depressive disorders
  • independent prescriber
  • pharmacist
  • primary care
  • research evaluation
  • Scotland


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