Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B

Objectives Respiratory tract infections are frequently managed by nurse and pharmacist prescribers, and these prescribers are responsible for 8% of all primary care antibiotic prescriptions. Few studies have explored antibiotic prescribing among these prescribers, and interventions to target their a...

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Main Authors: Rosemary Lim, Molly Courtenay, Sarah Peters, Angel Chater, Samantha Rowbotham, Kathryn Yates
Format: Article
Language:English
Published: BMJ Publishing Group 2019-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/6/e029177.full
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author Rosemary Lim
Molly Courtenay
Sarah Peters
Angel Chater
Samantha Rowbotham
Kathryn Yates
author_facet Rosemary Lim
Molly Courtenay
Sarah Peters
Angel Chater
Samantha Rowbotham
Kathryn Yates
author_sort Rosemary Lim
collection DOAJ
description Objectives Respiratory tract infections are frequently managed by nurse and pharmacist prescribers, and these prescribers are responsible for 8% of all primary care antibiotic prescriptions. Few studies have explored antibiotic prescribing among these prescribers, and interventions to target their antibiotic prescribing behaviour do not exist. Research objectives were to: (1) use the Theoretical Domains Framework to identify the factors that influence nurse and pharmacist prescriber management of respiratory tract infections and (2) identify the behaviour change techniques (BCTs) that can be used as the basis for the development of a theoretically informed intervention to support appropriate prescribing behaviour.Design Qualitative design comprising semistructured interviews, using the Theoretical Domains Framework and Capability, Opportunity and Motivation for Behaviour.Setting Primary care.Participants Twenty one prescribers (4 pharmacists and 17 nurses).Results A range of factors across 12 domains of the TDF were found to influence prescriber behaviour, and 40 BCTs were identified as supporting appropriate prescribing. For example, patient expectations (social influence) was identified as a factor influencing prescribing decisions, and a number of BCTs (problem solving, goal setting and information about health consequences) were identified as supporting prescribers in managing these expectations.Conclusion With increasing numbers of nurse and pharmacist prescribers managing infections in primary care, these findings will inform theoretically grounded interventions to support appropriate prescribing behaviour by these groups.
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spelling doaj-art-4c7f48c089584c6fa64daca2300b8d0c2024-11-22T23:20:12ZengBMJ Publishing GroupBMJ Open2044-60552019-06-019610.1136/bmjopen-2019-029177Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-BRosemary Lim0Molly Courtenay1Sarah Peters2Angel Chater3Samantha Rowbotham4Kathryn Yates5Reading School of Pharmacy, University of Reading School of Chemistry Food and Pharmacy, Reading, UK1 School of Healthcare Sciences, Cardiff University, Cardiff, UK4 Health Sciences, University of Manchester, Manchester, UKCentre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedfordshire, UK2 Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia5 Londonwide LMC, Londonwode LMCs and Londonwide Enterprise Ltd, London, UK, UKObjectives Respiratory tract infections are frequently managed by nurse and pharmacist prescribers, and these prescribers are responsible for 8% of all primary care antibiotic prescriptions. Few studies have explored antibiotic prescribing among these prescribers, and interventions to target their antibiotic prescribing behaviour do not exist. Research objectives were to: (1) use the Theoretical Domains Framework to identify the factors that influence nurse and pharmacist prescriber management of respiratory tract infections and (2) identify the behaviour change techniques (BCTs) that can be used as the basis for the development of a theoretically informed intervention to support appropriate prescribing behaviour.Design Qualitative design comprising semistructured interviews, using the Theoretical Domains Framework and Capability, Opportunity and Motivation for Behaviour.Setting Primary care.Participants Twenty one prescribers (4 pharmacists and 17 nurses).Results A range of factors across 12 domains of the TDF were found to influence prescriber behaviour, and 40 BCTs were identified as supporting appropriate prescribing. For example, patient expectations (social influence) was identified as a factor influencing prescribing decisions, and a number of BCTs (problem solving, goal setting and information about health consequences) were identified as supporting prescribers in managing these expectations.Conclusion With increasing numbers of nurse and pharmacist prescribers managing infections in primary care, these findings will inform theoretically grounded interventions to support appropriate prescribing behaviour by these groups.https://bmjopen.bmj.com/content/9/6/e029177.full
spellingShingle Rosemary Lim
Molly Courtenay
Sarah Peters
Angel Chater
Samantha Rowbotham
Kathryn Yates
Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
BMJ Open
title Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
title_full Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
title_fullStr Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
title_full_unstemmed Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
title_short Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B
title_sort examining influences on antibiotic prescribing by nurse and pharmacist prescribers a qualitative study using the theoretical domains framework and com b
url https://bmjopen.bmj.com/content/9/6/e029177.full
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