Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

Lucy Sargent, Amanda McCullough, Chris Del Mar, John Lowe

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)
58 Downloads (Pure)

Abstract

Background: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia. Methods: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. Results: The interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Conclusions: Using a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.

Original languageEnglish
Article number20
JournalBMC Family Practice
Volume18
Issue number1
DOIs
Publication statusPublished - 13 Feb 2017

Fingerprint

General Practitioners
Theoretical Models
Anti-Bacterial Agents
Pharmacists
Respiratory Tract Infections
General Practice
Prescriptions
Interviews
Decision Making
Emotions

Cite this

@article{4a82935c19c54275ad6f33996c5190fb,
title = "Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel",
abstract = "Background: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia. Methods: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. Results: The interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Conclusions: Using a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.",
author = "Lucy Sargent and Amanda McCullough and {Del Mar}, Chris and John Lowe",
year = "2017",
month = "2",
day = "13",
doi = "10.1186/s12875-017-0589-1",
language = "English",
volume = "18",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BMC",
number = "1",

}

TY - JOUR

T1 - Using theory to explore facilitators and barriers to delayed prescribing in Australia

T2 - a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

AU - Sargent, Lucy

AU - McCullough, Amanda

AU - Del Mar, Chris

AU - Lowe, John

PY - 2017/2/13

Y1 - 2017/2/13

N2 - Background: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia. Methods: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. Results: The interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Conclusions: Using a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.

AB - Background: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia. Methods: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. Results: The interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Conclusions: Using a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.

UR - http://www.scopus.com/inward/record.url?scp=85012920655&partnerID=8YFLogxK

U2 - 10.1186/s12875-017-0589-1

DO - 10.1186/s12875-017-0589-1

M3 - Article

VL - 18

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

IS - 1

M1 - 20

ER -