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

  • Molly Courtenay
    ,
  • Samantha Rowbotham
    ,
  • Rosemary Lim
    ,
  • Sarah Peters
    ,
  • Kathryn Yates
    ,
  • Angel Chater
  • Cardiff University
    ,
  • University of Sydney
    ,
  • University of Reading
    ,
  • University of Manchester
    ,
  • Londonwode LMCs and Londonwide Enterprise Ltd
Research Output:
Contribution to journal
Article
 Peer-review

Open access

Abstract

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. Qualitative design comprising semistructured interviews, using the Theoretical Domains Framework and Capability, Opportunity and Motivation for Behaviour. Primary care. Twenty one prescribers (4 pharmacists and 17 nurses). 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. 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. OBJECTIVES DESIGN SETTING PARTICIPANTS RESULTS CONCLUSION

Publication Information

Output type

Research Output:
Contribution to journal
Article
 Peer-review

Original language

English

Pages from-to (Number of pages)

Pages e029177

Journal (Volume, Issue Number)

BMJ Open (Volume 9, Issue 6)

Publication milestones

  • Accepted/In press - 29/05/2019
  • Published - 19/06/2019

Publication status

Published - 19/06/2019

Publication IDs

  • handle.net: 10547/623619
  • Scopus: 85067855165

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