Exploring the Responses of Prescribing Pharmacists and Family Physicians to Common Cases of Ambulatory Conditions
Bibliographic record
Abstract
Changes in the scope of practice of pharmacists have granted prescribing privileges to pharmacists in various jurisdictions. While seen as a natural progression of the expertise of pharmacy professionals by some, prescribing pharmacists have also been met with a range of cautionary warnings regarding proficiency and appropriateness because of the traditional training of pharmacists. Different models of prescribing pharmacist continue to be considered and implemented particularly regarding the treatment of ambulatory conditions, sometimes referred to as minor illness or ailments. Studies seeking to characterize the parameters of prescribing pharmacists with respect to ambulatory conditions such as clinical reasoning and clinical decision-making have been limited to using qualitative measures as well as focusing on a single prototypical clinical case. The following thesis describes a study which an online survey of multiple clinical cases of common ambulatory conditions was used to quantitatively assess the performance and behaviors of prescribing pharmacists in Alberta, Canada using family physicians as a comparison group. Participants were asked to respond to the clinical cases with diagnostic and therapeutic selections as well as report confidence in both selections. The prescribing pharmacists were hypothesized to demonstrate lower performance and confidence in selections compared to family physician counterparts due to aforementioned differences in training. The findings of the study concluded that were no significant differences in the diagnostic and therapeutic selection scores or in the reported confidence levels between a sample of prescribing pharmacists and family physicians. This research provides some of the first baseline evidence demonstrating the capabilities of prescribing pharmacists in the assessment and treatment of a range of ambulatory conditions. Future studies building on these findings should seek to understand how prescribing pharmacists can be better integrated into the healthcare system, particularly by using the methods of this study as a framework for the assessment of pharmacist in training and in practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".