Abstract
BackgroundNon-medical prescribing is one healthcare reform strategy that has the potential to create savings in the health system as well as offer equitable and timely access to scheduled medicines. Currently there is a lack of information about prescribing practices of Australian podiatrists, making it difficult to assess if endorsement for scheduled medicines (endorsement) for podiatrists provides health system efficiencies or improved patient access and outcomes. Further, the uptake for endorsement remains low among Australian podiatrists. The aim of this research was to investigate the prescribing practices among Australian podiatrists as well as to explore barriers and facilitators that influence participation in endorsement. MethodsParticipants in this quantitative, cross-sectional study were registered and practicing Australian podiatrists and podiatric surgeons who were recruited through a combination of professional networks, social media, and personal contacts. Respondents were invited to complete a customised self-reported online survey. The survey was developed using previously published research, research team’s expertise and piloted with podiatrists. The survey contained three sections: demographic data including clinical experience, questions pertaining to prescribing practices, and barriers and facilitators of the endorsement pathway. ResultsRespondents (n = 225) were predominantly female, aged 25-45, working in the private sector. Approximately one quarter were endorsed (15%) or in training to become endorsed (11%). Of the 168 non-endorsed respondents, 66% reported that they would like to undertake training to become an endorsed prescriber. The medications most frequently prescribed include local anaesthetics, antimycotics, antibacterial agents, and analgesia. The most common indications reported for prescribing these medications include nail surgery (71%), foot infections and ulcerations (88%), post-operative pain (67%), and mycosis (95%). The most prescribed Schedule 2 medications were ibuprofen, paracetamol, and topical terbinafine. The most prescribed Schedule 4 medicines among endorsed podiatrists included lignocaine (84%), Cephalexin (68%), Flucloxacillin (68%), and Amoxicillin with Clavulanic acid (61%). ConclusionWhile podiatrists predominantly prescribe to assist pain, inflammatory, or infectious conditions, lack of public funding and pathology testing access limit podiatrists’ ability to maximise prescribing opportunities. Many barriers exist in the current endorsement for podiatrists, particularly related to training processes, including mentor access and supervised practice opportunities, requiring targeted enabling strategies.