Table 2

Ranking of Theoretical Domains Framework (TDF) domains

TDF domain (in ranking order)	Frequency * (max n=13 studies)	Elaboration † (number of influences)	Bidirectionality ‡	Types of influences on antibiotic prescribing
1. Beliefs about consequences	13	33	Yes	Evidence and education Clinical experience Clinical assessment Knowledge and perceptions of patient Perceptions of patient expectations and satisfaction Time and workload Awareness and perception of responsibility for AMR Costs associated with prescribing Legal issues Attitudes to and use of AMS strategies
2. Social influences	12	13	Yes	Knowledge and perceptions of patient Perceptions of patient expectations and satisfaction Communication skills and strategies Monitoring, auditing, feedback and accountability Perceptions of own and others’ prescribing
3. Skills	11	8	Yes	Communication skills and strategies Perceptions of patient expectations and satisfaction
4. Environmental context and resources	10	12	Yes	Time and workload Perceptions of own and others’ prescribing Attitudes to and use of AMS strategies
5. Intentions §	10	7	Yes	Evidence and education Perceptions of patient expectations and satisfaction Communication skills and strategies Attitudes to and use of AMS strategies
6. Emotions ¶	10	3	Yes	Clinical experience (eg, concern related to it) Legal issues (eg, concern with it)
7. Social / professional role and identity	8	10	Yes	Perception of professional role and ethos Communication skills and strategies Monitoring, auditing, feedback and accountability **
8. Knowledge	7	6	Yes	Evidence and education Awareness and perception of responsibility for AMR Monitoring, auditing, feedback and accountability**
9. Beliefs about capabilities	5	4	Yes	Clinical experience and confidence
10. Memory, attention, decision processes	1	2	Yes	Awareness and perceptions of responsibility for AMR (responding to immediate pressures over long-term consequences or vice versa) ††
11. Reinforcement	2	1	No	Attitudes to and use of AMS strategies (use of financial incentives)

*Number of studies in which the TDF domain was identified.
†Number of influences identified in studies in each TDF domain.
‡Bidirectionality was when the influence could be either a barrier or a facilitator to appropriate prescribing (eg, the influence ‘knowledge of evidence or guidelines’ could be a barrier (ie, a lack of knowledge of evidence or guidelines) or a facilitator (ie, having knowledge of evidence and guidelines).
§TDF domain ‘intentions’ was double-coded with TDF domains ‘skills’ and ‘beliefs about consequences’.
¶TDF domain ‘emotions’ was double-coded with TDF domain 'beliefs about consequences'.
**Some influences included in the theme ‘Monitoring, auditing, feedback and accountability’ were also double-coded with TDF domain ‘social influences’.
††Some influences included in the theme ‘Awareness & perceptions of responsibility for AMR’ were also double-coded with TDF domain 'beliefs about consequences'.
AMR, antimicrobial resistance ; AMS, antimicrobial stewardship.