School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Int J Pharm Pract. 2023 Jun 30;31(4):396-402. doi: 10.1093/ijpp/riad019.
Inappropriate prescribing, particularly for analgesia, is a recognised global problem. This leads to increased morbidity and mortality and presents a significant challenge for patients and the healthcare system. There is a need to identify strategies that best identify inappropriately prescribed analgesia (IPA). This study aims to explore the perspectives and experiences of community pharmacists (CPs) about addressing IPA.
Semi-structured interviews informed by the Behaviour Change Wheel model and the Theoretical Domains Framework (TDF) were conducted with consenting community pharmacists. Transcripts were coded using a capability, opportunity, motivation model of behaviour (COM-B) model. The COM-B components were mapped to the TDF and behaviour change techniques (BCTs) were identified to address these.
A total of 12 pharmacists who work in community pharmacies in England were interviewed between March and May 2021. COM-B components were identified through analysis and mapped to nine TDF domains. Component 1 referred to 'Capability' of CPs to be involved in addressing IPA (knowledge). Component 2 pertained to 'Opportunity' to identify IPA (e.g. social influence). The 'Motivation' component linked to five TDF domains (e.g. goals). Seventeen BCTs were identified to support CPs in addressing IPA (e.g. environmental context and resources domain mapped to 2 BCTs 'restructuring the physical and social environment').
CPs expressed mixed perceptions about their involvement in the deprescribing of IPA as part of their daily practice, but they stated that social and environmental barriers needed to be addressed to facilitate their involvement. The identified BCTs provide evidence-based strategies to help the involvement of CPs to identify IPA.
不适当的处方,特别是在镇痛方面,是一个公认的全球性问题。这导致发病率和死亡率增加,并对患者和医疗保健系统构成重大挑战。因此,需要确定最佳的策略来识别不适当的处方(IPA)。本研究旨在探讨社区药剂师(CPs)对解决 IPA 的看法和经验。
采用行为改变车轮模型和理论领域框架(TDF),对同意参与的社区药剂师进行半结构化访谈。使用行为的能力、机会、动机模型(COM-B)模型对转录本进行编码。将 COM-B 组件映射到 TDF 上,并确定行为改变技术(BCT)来解决这些问题。
2021 年 3 月至 5 月期间,共对英格兰社区药房的 12 名药剂师进行了访谈。通过分析确定了 COM-B 组件,并将其映射到 TDF 的九个领域。第 1 个组件涉及 CP 参与解决 IPA 的“能力”(知识)。第 2 个组件与识别 IPA 的“机会”有关(例如社会影响)。“动机”组件与 TDF 的五个领域相关(例如目标)。确定了 17 个 BCT 来支持 CP 解决 IPA(例如环境上下文和资源领域映射到 2 个 BCT“重构物理和社会环境”)。
CPs 对他们在日常实践中参与减少 IPA 处方的看法不一,但他们表示需要解决社会和环境障碍,以促进他们的参与。确定的 BCT 为帮助 CP 参与识别 IPA 提供了基于证据的策略。