Intervention recommendations for community pharmacy using the Theoretical Domains Framework (TDF), Behaviour Change Wheel and behaviour change techniques taxonomy v1
Finding | TDF domains | COM-B (Capability, Opportunity, Motivation - Behaviour) | Intervention functions (selected) | Behaviour change techniques (selected) | Recommendations and examples |
1. Lack of communication with Clinical Commissioning Groups (CCGs). | Environmental context and resources. | Physical opportunity. | Training Environmental restructuring Enablement. | Restructuring the physical environment Social support. | Better communication links with CCGs are needed: CCGs to promote antimicrobial stewardship in community pharmacies or lead on audits. |
2. Time is an issue for pharmacists. 3. Misinformation can be given to patients. | Environmental context and resources | Physical opportunity | Training Environmental restructuring Enablement. | Adding objects to the environment Instruction on how to perform a behaviour. | Resource for all pharmacy staff to provide self-care information to patients for example, patient information leaflet. |
4. Belief that patients do not comply. 5. Belief that patients are not interested in compliance advice. | Beliefs about consequences. | Reflective motivation. | Education Persuasion. | Information about health consequences (for patients) Credible sources Prompts/cues. | Compliance advice resources: 1. A leaflet to be shared with the patient and discussed. 2. A leaflet to be inserted into the prescription bag. 3. Stickers to place on the box with pictorial compliance information. |
6. Lack of feedback on self-care advice given. 7. Unaware of link between AMR and giving advice. | Memory, attention and decision-making. | Psychological capability. | Training Environmental restructuring Enablement. | Feedback on behaviour Self-monitoring of behaviour Goal setting Action planning. | Self-care advice audits: 1. An electronic audit within the pharmacy system. 2. A hard copy audit to be completed manually. Training on link between AMR and self-care advice. |
8. Lack of feedback on compliance advice given. | Memory, attention and decision-making. | Psychological capability. | Training Environmental restructuring Enablement. | Feedback on behaviour Self-monitoring of behaviour Goal setting Action planning. | Antibiotic compliance audits on advice given and actual compliance: 1. An electronic audit within the pharmacy system. 2. A hard copy audit to be completed manually. 3. Patient survey. |
9. Patient diagnosis is not available. 10. Unclear whether it is the pharmacist’s role to query antibiotic prescriptions. | Professional role and identity. | Reflective motivation. | Education Persuasion Modelling. | Information about health consequences. Feedback on outcomes of behaviour. Prompts/cues Credible source. | Provide prescription indications: 1. Provide coded diagnosis information on patient prescriptions. 2. Provide access to patient records. |
11. Advice is limited as pharmacists cannot provide examinations. | Professional role and identity. | Reflective motivation. | Education Persuasion Modelling. | Demonstration Information about health consequences Credible source. | Offer optional accredited medical training to pharmacists in patient examination to inform advice giving. |