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 B Del Mar; John B Lowe

doi:10.1186/s12875-017-0589-1

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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

Journal article

Open access

Peer reviewed

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 B Del Mar and John B Lowe

BMC Family Practice, Vol.18, 20

2017

DOI: https://doi.org/10.1186/s12875-017-0589-1

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Abstract

delayed prescribing

acute respiratory infections

antibiotics

theoretical

domains

framework

general practitioners

pharmacists

patients

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.

Details

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
Authors: Lucy Sargent (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
Amanda McCullough (Author) - Bond University
Chris B Del Mar (Author) - Bond University
John B Lowe (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
Publication details: BMC Family Practice, Vol.18, 20; 14
Publisher: BioMed Central Ltd.
Date published: 2017
DOI: 10.1186/s12875-017-0589-1
ISSN: 1471-2296
Copyright note: Copyright © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; External; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99451199602621
Output Type: Journal article

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