Analysis of the Cochrane Review: Non-medical Prescribing versus Medical Prescribing for Acute and Chronic Disease Management in Primary and Secondary Care. Cochrane Database Syst Rev. 2016;11:CD011227

Acta Médica Portuguesa
Gonçalo Silva DuarteAntónio Vaz-Carneiro

Abstract

In countries with diverse socioeconomic levels, in order to address the health care demands, the consideration of a wide array of strategies is needed; among these, non-medical prescription can be included. The objective of this revision was to ascertain whether non-medical prescription results in comparable clinical and patient-related outcomes to medical prescription. This systematic review was conducted in compliance with the standard Cochrane methodology. Clinical outcomes were compared between prescription carried out by non-medical health professionals and doctors, provided that the non-medical health professional prescribed with a high degree of autonomy, both in hospital and community practice, in countries with low, medium and high socioeconomic level. The review included 46 clinical trials, with different designs, with 37 337 participants overall. Most studies were based on the management of chronic disease in higher income countries, where the evidence supports comparable outcomes for the markers of disease relative to high blood pressure (moderate-certainty of evidence), diabetes control (high-certainty of evidence); high cholesterol (moderatecertainty of evidence), among others. Prescription by pharmacists and nurs...Continue Reading

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