Table 2

Intervention recommendations for community pharmacy using the Theoretical Domains Framework (TDF), Behaviour Change Wheel and behaviour change techniques taxonomy v1

FindingTDF domainsCOM-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 resourcesPhysical opportunityTraining
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.