Exploring non-medical prescribing for patients with mental illness: a scoping review

Abstract Background Non-medical prescribing (NMP) qualifications extend prescribing authority to nurses, pharmacists, and other allied health professionals and are advocated as a means to help improve healthcare efficiency and access to services. However, despite non-medical prescribers (NMPs) being...

Full description

Saved in:
Bibliographic Details
Main Authors: Bashayr A Alsaeed, Jason Hall, Richard N. Keers
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06938-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850268936237481984
author Bashayr A Alsaeed
Jason Hall
Richard N. Keers
author_facet Bashayr A Alsaeed
Jason Hall
Richard N. Keers
author_sort Bashayr A Alsaeed
collection DOAJ
description Abstract Background Non-medical prescribing (NMP) qualifications extend prescribing authority to nurses, pharmacists, and other allied health professionals and are advocated as a means to help improve healthcare efficiency and access to services. However, despite non-medical prescribers (NMPs) being utilised in some countries for more than two decades, less is known about their role and impact in the mental health context. This scoping review therefore aims to map published research evidence concerning NMP for patients with mental illness. Methods Five electronic databases were searched from January 2003 to July 2024. Reference lists of identified papers were also checked for relevant studies. Full text primary research studies exploring the nature, impact, and implementation of NMP services for patients with mental illness and dementia in community settings were included. Results From 22,547 retrieved papers, 63 studies were included. Of these, 57 (90.4%) detailed the nature (including the service or team they were based in, medicines prescribed, and main role(s)) of NMPs, 45 (71.4%) assessed the impact of services, and 16 (25.3%) explored factors influencing service implementation and delivery. The majority of studies originated from the USA (30/63, 47.6%), or the United Kingdom (27/63, 42.8%). Either nurse (44/63, 69.8%), pharmacist (16/63, 25.3%) or non-medical prescribing models featuring both professionals were exclusively studied (3/63, 4.7%). In the UK and USA, antidepressants (60%, 54.5%) were the most prescribed by NMPs. Although the conditions of patients managed by both nurse and pharmacist prescribers were reported to be well managed based on clinical outcomes (3/24, 12.5% and 3/13, 23%, respectively), few studies evaluated health outcomes. Training-related barriers to service delivery were commonly mentioned in UK studies (4/9, 44.4%), with financial issues reported in the USA (2/4, 50%). Conclusions This review highlights the diverse roles of NMPs in the care of people with mental illness. Whilst the limited evidence suggests a positive impact on patient care, more quantitative research is needed. Given the focus on nursing prescriber models in this review, along with rising mental health demand and continuing staff shortages, future research should prioritise exploring and evaluating the contribution of pharmacist NMP services as well other healthcare professionals' NMPs.
format Article
id doaj-art-34cc6da345a2414db41e9e2bf3f58e81
institution OA Journals
issn 1471-244X
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Psychiatry
spelling doaj-art-34cc6da345a2414db41e9e2bf3f58e812025-08-20T01:53:19ZengBMCBMC Psychiatry1471-244X2025-05-0125112810.1186/s12888-025-06938-6Exploring non-medical prescribing for patients with mental illness: a scoping reviewBashayr A Alsaeed0Jason Hall1Richard N. Keers2Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of ManchesterDivision of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of ManchesterDivision of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of ManchesterAbstract Background Non-medical prescribing (NMP) qualifications extend prescribing authority to nurses, pharmacists, and other allied health professionals and are advocated as a means to help improve healthcare efficiency and access to services. However, despite non-medical prescribers (NMPs) being utilised in some countries for more than two decades, less is known about their role and impact in the mental health context. This scoping review therefore aims to map published research evidence concerning NMP for patients with mental illness. Methods Five electronic databases were searched from January 2003 to July 2024. Reference lists of identified papers were also checked for relevant studies. Full text primary research studies exploring the nature, impact, and implementation of NMP services for patients with mental illness and dementia in community settings were included. Results From 22,547 retrieved papers, 63 studies were included. Of these, 57 (90.4%) detailed the nature (including the service or team they were based in, medicines prescribed, and main role(s)) of NMPs, 45 (71.4%) assessed the impact of services, and 16 (25.3%) explored factors influencing service implementation and delivery. The majority of studies originated from the USA (30/63, 47.6%), or the United Kingdom (27/63, 42.8%). Either nurse (44/63, 69.8%), pharmacist (16/63, 25.3%) or non-medical prescribing models featuring both professionals were exclusively studied (3/63, 4.7%). In the UK and USA, antidepressants (60%, 54.5%) were the most prescribed by NMPs. Although the conditions of patients managed by both nurse and pharmacist prescribers were reported to be well managed based on clinical outcomes (3/24, 12.5% and 3/13, 23%, respectively), few studies evaluated health outcomes. Training-related barriers to service delivery were commonly mentioned in UK studies (4/9, 44.4%), with financial issues reported in the USA (2/4, 50%). Conclusions This review highlights the diverse roles of NMPs in the care of people with mental illness. Whilst the limited evidence suggests a positive impact on patient care, more quantitative research is needed. Given the focus on nursing prescriber models in this review, along with rising mental health demand and continuing staff shortages, future research should prioritise exploring and evaluating the contribution of pharmacist NMP services as well other healthcare professionals' NMPs.https://doi.org/10.1186/s12888-025-06938-6Non-medical prescribingNurse prescriberPharmacist prescribersMental health
spellingShingle Bashayr A Alsaeed
Jason Hall
Richard N. Keers
Exploring non-medical prescribing for patients with mental illness: a scoping review
BMC Psychiatry
Non-medical prescribing
Nurse prescriber
Pharmacist prescribers
Mental health
title Exploring non-medical prescribing for patients with mental illness: a scoping review
title_full Exploring non-medical prescribing for patients with mental illness: a scoping review
title_fullStr Exploring non-medical prescribing for patients with mental illness: a scoping review
title_full_unstemmed Exploring non-medical prescribing for patients with mental illness: a scoping review
title_short Exploring non-medical prescribing for patients with mental illness: a scoping review
title_sort exploring non medical prescribing for patients with mental illness a scoping review
topic Non-medical prescribing
Nurse prescriber
Pharmacist prescribers
Mental health
url https://doi.org/10.1186/s12888-025-06938-6
work_keys_str_mv AT bashayraalsaeed exploringnonmedicalprescribingforpatientswithmentalillnessascopingreview
AT jasonhall exploringnonmedicalprescribingforpatientswithmentalillnessascopingreview
AT richardnkeers exploringnonmedicalprescribingforpatientswithmentalillnessascopingreview