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

Courtenay, Molly ORCID: https://orcid.org/0000-0002-8639-5917, Rowbotham, Samantha, Lim, Rosemary, Peters, Sarah, Yates, Kathryn and Chater, Angel 2019. Examining influences on antibiotic prescribing by nurse and pharmacist prescribers: a qualitative study using the Theoretical Domains Framework and COM-B. BMJ Open 9 , e029177. 10.1136/bmjopen-2019-029177

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Abstract

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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Publisher:	BMJ Publishing Group
ISSN:	2044-6055
Date of First Compliant Deposit:	19 July 2019
Date of Acceptance:	29 May 2019
Last Modified:	05 May 2023 18:21
URI:	https://orca.cardiff.ac.uk/id/eprint/124360

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