Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework
BackgroundFew 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 Fram...
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| مؤلفون آخرون: | , , , , , , |
| التنسيق: | article |
| منشور في: |
2024
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| الوصول للمادة أونلاين: | http://dx.doi.org/10.1016/j.sapharm.2023.12.009 https://www.sciencedirect.com/science/article/pii/S1551741123005144 http://hdl.handle.net/10576/54498 |
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| _version_ | 1857415086594850816 |
|---|---|
| author | Hend, Talkhan |
| author2 | Stewart, Derek McIntosh, Trudi Ziglam, Hisham Abdulrouf, Palli Valappila Al-Hail, Moza Diab, Mohammad Cunningham, Scott |
| author2_role | author author author author author author author |
| author_facet | Hend, Talkhan Stewart, Derek McIntosh, Trudi Ziglam, Hisham Abdulrouf, Palli Valappila Al-Hail, Moza Diab, Mohammad Cunningham, Scott |
| author_role | author |
| dc.creator.none.fl_str_mv | Hend, Talkhan Stewart, Derek McIntosh, Trudi Ziglam, Hisham Abdulrouf, Palli Valappila Al-Hail, Moza Diab, Mohammad Cunningham, Scott |
| dc.date.none.fl_str_mv | 2024-04-30T06:48:10Z 2024-01-03 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.sapharm.2023.12.009 Talkhan, 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. 1551-7411 https://www.sciencedirect.com/science/article/pii/S1551741123005144 http://hdl.handle.net/10576/54498 4 20 1934-8150 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Anti-bacterial agents Anti-infective agents Inappropriate prescribing Theoretical Domains Framework Qatar Barrier/ facilitator |
| dc.title.none.fl_str_mv | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | BackgroundFew 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_b60afbea77022b0f260ff85121679183 |
| identifier_str_mv | Talkhan, 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. 1551-7411 4 20 1934-8150 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/54498 |
| publishDate | 2024 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| spelling | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains FrameworkHend, TalkhanStewart, DerekMcIntosh, TrudiZiglam, HishamAbdulrouf, Palli ValappilaAl-Hail, MozaDiab, MohammadCunningham, ScottAnti-bacterial agentsAnti-infective agentsInappropriate prescribingTheoretical Domains FrameworkQatarBarrier/ facilitatorBackgroundFew 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.This work was supported by the MRC , HMC , Qatar [grant number MRC-01-19-219 ].Elsevier2024-04-30T06:48:10Z2024-01-03Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.sapharm.2023.12.009Talkhan, 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.1551-7411https://www.sciencedirect.com/science/article/pii/S1551741123005144http://hdl.handle.net/10576/544984201934-8150enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/544982025-05-25T09:34:43Z |
| spellingShingle | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework Hend, Talkhan Anti-bacterial agents Anti-infective agents Inappropriate prescribing Theoretical Domains Framework Qatar Barrier/ facilitator |
| status_str | publishedVersion |
| title | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| title_full | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| title_fullStr | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| title_full_unstemmed | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| title_short | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| title_sort | Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework |
| topic | Anti-bacterial agents Anti-infective agents Inappropriate prescribing Theoretical Domains Framework Qatar Barrier/ facilitator |
| url | http://dx.doi.org/10.1016/j.sapharm.2023.12.009 https://www.sciencedirect.com/science/article/pii/S1551741123005144 http://hdl.handle.net/10576/54498 |