Knowledge, attitude, and perception of nurses, physicians, and patients regarding nurse prescribing role in Pakistan

Authors

  • Altaf Hussain Ph.D Candidate, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand https://orcid.org/0000-0002-3780-9642
  • Shaista Parveen College of Nursing Female, Sukkur, Pakistan
  • Kanwal Fida Hussain College of Nursing Female, Sukkur, Pakistan
  • Aneesa Ubedullah College of Nursing Female, Sukkur, Pakistan
  • Kiran Murad College of Nursing Female, Sukkur, Pakistan
  • Sharmeela Malha College of Nursing Female, Sukkur, Pakistan
  • Mehtab Mehtab Dow University of Health Sciences, Karachi, Pakistan

DOI:

https://doi.org/10.63868/npjn.v2i1.83

Keywords:

Knowledge Level, Perception, Attitude, Nurse prescribing ole, Pakistan

Abstract

Background: Nurse prescribing roles are increasingly adopted by global healthcare systems to address workforce shortages and enhance patient access. However, the potential for implementing such roles in Pakistan has not been thoroughly investigated. This study examined the knowledge, attitudes, and perceptions of nurses, physicians, and patients regarding nurse prescribing in Pakistan.

Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital in Sukkur, Pakistan. A quota-based non-random sampling approach was used to recruit 200 participants, including registered nurses, physicians, and patients. Data were collected using a validated questionnaire (Cronbach’s α=0.75) and analyzed with descriptive statistics, Chi-square tests, and ANOVA (p<0.05).

Results: Awareness of nurse prescribing was reported by 82.9% of nurses and 70.0% of physicians. Despite this, support for independent prescribing remained limited; 80.0% of patients, 68.6% of physicians, and 48.6% of nurses preferred the role to remain strictly under physician supervision. Nurses demonstrated the most positive attitudes toward nurse prescribing (38.1%), while physicians achieved the highest knowledge scores (4.91±2.21). Statistically significant differences were observed among the groups in both knowledge (F=24.27, p<0.001) and attitudes (F=34.72, p<0.001).

Conclusion: Although Pakistani nurses exhibit readiness and positive attitudes toward prescribing, significant barriers persist, such as physician resistance and limited patient trust. Effective integration of nurse prescribing roles will require strengthened nursing curricula, the establishment of clear regulatory frameworks, and improved interprofessional collaboration.

References

Alhazmi, W. R., Alenez, L. A. S., Asri, R., Alhazmi, M., Hulayyil, H., Alruwaili, B., Tawih, R., Alrwili, S., Zaalalhazmi, M., Alanazi, Y. S., T., M. M., Alhazmy, T., Othman, M., Alhazmi, M., Rubayyi, A., Alruwaili, D., Mulayhan, A., & Alanazi. (2024). Nursing-led management of chronic diseases in primary healthcare. International Journal of Computational and Experimental Science and Engineering.

Alruwaili, M. J. J., Alwallah, S. A., ALRuwaili, F. S., Asmari, M. A., AlRowily, R. T. S., Alghamedi, F. H., Alenazi, E. M., Alanazi, A. D., Alshammari, W. F., & Alghamedi, N. H. A. (2024). The role of nursing in managing chronic illness: A review of patient outcomes and quality of life. Journal of Ecohumanism.

Bandi, V., Dey, S. K., & Rao, O. (2024). Factors influencing the physician prescribing behaviour of medicines in developed and developing countries: A systematic review. Journal of Integrative Nursing and Palliative Care, 5(1), 21–34.

Barreto, M. d. S., Marquete, V. F., Camparoto, C. W., García‐Vivar, C., Barbieri‐Figueiredo, M. d. C., & Marcon, S. S. (2022). Factors associated with nurses’ positive attitudes towards families’ involvement in nursing care: A scoping review. Journal of Clinical Nursing, 31(23-24), 3338–3349.

Fazal, A., & Ul-Haq, I. (2023). Ethical dilemmas faced by nurse practitioners and physician assistants within managed care settings. Pakistan Journal of Ethics, 3(2), 29–33.

Fong, J., Buckley, T., & Cashin, A. (2015). Nurse practitioner prescribing: An international perspective. Nursing: Research and Reviews, 99–108.

Hammarberg, C., Abelsson, A., Arslan, A., & Willman, A. (2024). Independent and effective care–District nurses’ experiences of prescribing drugs: A systematic qualitative literature review. Nordic Journal of Nursing Research, 44.

Haririan, H., Rahmani, A., Porter, J. E., Heidarzadeh, M., Azadi, A., Faghani, S., & Moradi, N. (2021). Nursing students’ attitude and preparedness for nurse prescribing and its relationship with self-efficacy. Nurse Education in Practice, 54, Article 103126.

Haririan, H., Seresht, D. M., Hassankhani, H., Porter, J. E., & Wytenbroek, L. (2022). Nurses, physicians and patients’ knowledge and attitudes about nurse prescribing. BMC Nursing, 21(1), Article 112.

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances, 3, Article 100034.

Ivanenko, G. (2025). Global healthcare trends: Challenges and opportunities. Publìčne Upravlìnnâ ta Regìonalʹnij Rozvitok. https://doi.org/10.34132/pard2025.30.08

Jiao, S., Murimi, I. B., Stafford, R. S., Mojtabai, R., & Alexander, G. C. (2018). Quality of prescribing by physicians, nurse practitioners, and physician assistants in the United States. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 38(4), 417–427.

Laurant, M., van der Biezen, M., Wijers, N., Watananirun, K., Kontopantelis, E., & van Vught, A. (2018). Nurses as substitutes for doctors in primary care. Cochrane Database of Systematic Reviews, (7).

Lim, A. G., North, N., & Shaw, J. (2014). Nurse prescribing: The New Zealand context. Nursing Praxis in New Zealand Inc, 30(2), 18–27.

Luan, S. (2024). Aging populations and healthcare policy: Challenges and successes. Interdisciplinary Humanities and Communication Studies, 1(10). https://doi.org/10.61173/8d88qa11

Maier, C. B., Köppen, J., & Busse, R. (2018). Task shifting between physicians and nurses in acute care hospitals: Cross-sectional study in nine countries. Human Resources for Health, 16(1), Article 24.

Malik, E., & Shankar, S. (2023). Empowering nurses: Exploring self-managed organizations in Indian healthcare. BMC Nursing, 22(1), Article 477.

Mohammed, S., Hammad, I., Mohammed, F., Al Khatim, S., Sharief, H., Aldahmshi, S., Alenezi, J. M., Mohammed, N., Alruwaili, H., Waqqaf, E., Alruwaili, Q., Mahli, S., Alanazi, M., Alanazi, A. D., Intisar, B., Talaq, G., Alanazi, A., Jurayyan, M., Alanazi,

Nylund, S., Rauhala, A., Boman, E., Vaartio-Rajalin, H., & Fagerström, L. (2026). A national exploration of the utilisation of nurse prescribing in Finland: A cross-sectional survey in outpatient settings. BMC Nursing.

Piot, M. A., Dechartres, A., Attoe, C., Romeo, M., Jollant, F., Billon, G., Cross, S., Lemogne, C., Layat Burn, C., & Michelet, D. (2022). Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis. Journal of Advanced Nursing, 78(2), 332–347.

Rony, M. K. K., Numan, S. M., Johra, F. t., Akter, K., Akter, F., Debnath, M., Mondal, S., Wahiduzzaman, M., Das, M., & Ullah, M. (2024). Perceptions and attitudes of nurse practitioners toward artificial intelligence adoption in health care. Health Science Reports, 7(8), Article e70006.

Short, K., Andrew, C., Yang, W., & Jamieson, I. (2024). The impact of nurse prescribing on health care delivery for patients with diabetes: A rapid review. The Journal of Primary Health Care, 16(1), 78–89.

Smigorowsky, M. J., Sebastianski, M., McMurtry, M. S., Tsuyuki, R. T., & Norris, C. M. (2020). Outcomes of nurse practitioner‐led care in patients with cardiovascular disease: A systematic review and meta-analysis. Journal of Advanced Nursing, 76(1), 81–95.

Stenner, K., & Courtenay, M. (2008). Benefits of nurse prescribing for patients in pain: Nurses’ views. Journal of Advanced Nursing, 63(1), 27–35.

Wang, H., English, M., Chakma, S., Namedre, M., Hill, E., & Nagraj, S. (2022). The roles of physician associates and advanced nurse practitioners in the National Health Service in the UK: A scoping review and narrative synthesis. Human Resources for Health, 20(1), Article 69.

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State nurse practitioner practice regulations and US health care delivery outcomes: A systematic review. Medical Care Research and Review, 78(3), 183–196.

Zakary, A. K., Zakari, R. K., Modawi, A. M., Alnajei, S. A., Ghazwani, K. A., Garadi, J. A. Y., Hmlan, E. A., Najmi, H. M., Masrahi, E. A., & Otaif, H. A. (2024). The role of nurse practitioners in primary care settings: A comprehensive review. Egyptian Journal of Chemistry, 67(13), 781–791.

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Published

2026-05-21

How to Cite

Hussain, A., Parveen, S., Hussain, K. F., Ubedullah, A., Murad, K., Malha, S., & Mehtab, M. (2026). Knowledge, attitude, and perception of nurses, physicians, and patients regarding nurse prescribing role in Pakistan. Nurse Point: Journal of Nursing, 2(1), 70–78. https://doi.org/10.63868/npjn.v2i1.83