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AuthorHend, Talkhan
AuthorStewart, Derek
AuthorMcIntosh, Trudi
AuthorZiglam, Hisham
AuthorAbdulrouf, Palli Valappila
AuthorAl-Hail, Moza
AuthorDiab, Mohammad
AuthorCunningham, Scott
Available date2024-04-30T06:48:10Z
Publication Date2024-01-03
Publication NameResearch in Social and Administrative Pharmacy
Identifierhttp://dx.doi.org/10.1016/j.sapharm.2023.12.009
CitationTalkhan, H., Stewart, D., McINTOSH, T., Ziglam, H., Abdulrouf, P. V., Al-Hail, M., ... & Cunningham, S. (2024). Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework. Research in Social and Administrative Pharmacy.
ISSN1551-7411
URIhttps://www.sciencedirect.com/science/article/pii/S1551741123005144
URIhttp://hdl.handle.net/10576/54498
AbstractBackgroundFew theoretically-based, qualitative studies have explored determinants of antimicrobial prescribing behaviour in hospitals. Understanding these can promote successful development and implementation of behaviour change interventions (BCIs). Objective(s): To use the Theoretical Domains Framework (TDF) to explore determinants of clinicians’ antimicrobial prescribing behaviour, identifying barriers (i.e., impediments) and facilitators to appropriate antimicrobial practice. MethodsSemi-structured interviews with purposively-sampled doctors and pharmacists with a wide range of specialties and expertise in Hamad Medical Corporation hospitals in Qatar. Interviews based on previous quantitative research and the TDF were audio-recorded, transcribed and independently analysed by two researchers using the TDF as an initial coding framework. ResultsData saturation was achieved after interviewing eight doctors and eight pharmacists. Inter-related determinants of antimicrobial prescribing behaviour linked to ten TDF domains were identified as barriers and facilitators that may contribute to inappropriate or appropriate antimicrobial prescribing. The main barriers identified were around hospital guidelines and electronic system deficiencies (environmental context and resources); knowledge gaps relating to guidelines and appropriate prescribing (knowledge); restricted roles/responsibilities of microbiologists and pharmacists (professional role and identity); challenging antimicrobial prescribing decisions (memory, attention and decision processes); and professional hierarchies and poor multidisciplinary teamworking (social influences). Key facilitators included guidelines compliance (goals and intentions), and participants’ beliefs about the consequences of appropriate or inappropriate prescribing. Further education and training, and some changes to guidelines including their accessibility were also considered essential. ConclusionsAntimicrobial prescribing behaviour in hospitals is a complex process influenced by a broad range of determinants including specific barriers and facilitators. The in-depth understanding of this complexity provided by this work may support the development of an effective BCI to promote appropriate antimicrobial stewardship.
SponsorThis work was supported by the MRC , HMC , Qatar [grant number MRC-01-19-219 ].
Languageen
PublisherElsevier
SubjectAnti-bacterial agents
Anti-infective agents
Inappropriate prescribing
Theoretical Domains Framework
Qatar
Barrier/ facilitator
TitleExploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework
TypeArticle
Issue Number4
Volume Number20
Open Access user License http://creativecommons.org/licenses/by/4.0/
ESSN1934-8150
dc.accessType Full Text


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