Implementation of behaviour change training in practice amongst pharmacy professionals in primary care settings: Analysis using the COM-B model

Seston, Elizabeth; Willis, Sarah; Fenton, Catherine; Hindi, Ali; Moss, Aidan Akira; Stearns, Selma; Astbury, Jayne; Jacobs, Sally; McDermott, Imelda; Schafheutle, Ellen

doi:10.1016/j.sapharm.2023.04.123

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…This behaviour change model was considered helpful for framing the review findings, as successful implementation of integrated PC and HF can be essentially explained by HCPs’ capabilities, opportunities and motivation (or lack of) to integrate care. 36 …”

Section: Methodsmentioning

confidence: 99%

Integrating palliative care and heart failure: a systematic realist synthesis (PalliatHeartSynthesis)

McConnell,

Blair,

Burden

et al. 2023

Open Heart

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Objectives(1) Develop a programme theory of why, for whom and in what contexts integrated palliative care (PC) and heart failure (HF) services work/do not work; (2) use the programme theory to co-produce with stakeholders, intervention strategies to inform best practice and future research.MethodsA systematic review of all published articles and grey literature using a realist logic of analysis. The search strategy combined terms significant to the review questions: HF, PC and end of life. Documents were included if they were in English and provided data relevant to integration of PC and HF services. Searches were conducted in November 2021 in EMBASE, MEDLINE, PsycINFO, AMED, HMIC and CINAHL. Further relevant documents were identified via monthly alerts (up until April 2023) and the project stakeholder group (patient/carers, content experts and multidisciplinary practitioners).Results130 documents were included (86 research, 22 literature reviews, 22 grey literature). The programme theory identified intervention strategies most likely to support integration of PC and HF services. These included protected time for evidence-based PC and HF education from undergraduate/postgraduate level and continuing professional practice; choice of educational setting (eg, online, face-to-face or hybrid); increased awareness and seeing benefits of PC for HF management; conveying the emotive and intellectual need for integrating PC and HF via credible champions; and prioritising PC and HF guidelines in practice.ConclusionsThe review findings outline the required steps to take to increase the likelihood that all key players have the capacity, opportunity and motivation to integrate PC into HF management.PROSPERO registration numberCRD42021240185.

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Section: Methodsmentioning

confidence: 99%

Integrating palliative care and heart failure: a systematic realist synthesis (PalliatHeartSynthesis)

McConnell,

Blair,

Burden

et al. 2023

Open Heart

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“…The COM-B framework has previously been used to explore mechanisms of behaviour change in general practice settings and so was considered appropriate to use as a framework in our study. COM-B has been used for assessing quality improvement interventions such as behaviour change in documented assessment during routine consultations [ 39 ] and behaviour change through learning in practice for pharmacists in primary care settings [ 40 ]. It has also been used to help understand barriers and facilitators to chlamydia testing in general practice [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

CHIME-GP trial of online education for prescribing, pathology and imaging ordering in general practice – how did it bring about behaviour change?

Metusela,

Mullan,

Kobel

et al. 2023

BMC Health Serv Res

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Background There is a need for scalable clinician education in rational medication prescribing and rational ordering of pathology and imaging to help improve patient safety and enable more efficient utilisation of healthcare resources. Our wider study evaluated the effectiveness of a multifaceted education intervention for general practitioners (GPs) in rational prescribing and ordering of pathology and imaging tests, in the context of Australia’s online patient-controlled health record system, My Health Record (MHR), and found evidence for measurable behaviour change in pathology ordering among participants who completed the educational activities. This current study explored the mechanisms of behaviour change brought about by the intervention, with a view to informing the development of similar interventions in the future. Methods This mixed methods investigation used self-reported questionnaires at baseline and post-education on MHR use and rational prescribing and test ordering. These were analysed using multi-level ordinal logistic regression models. Semi-structured interviews pre- and post-intervention were also conducted and were analysed thematically using the COM-B framework. Results Of the 106 GPs recruited into the study, 60 completed baseline and 37 completed post-education questionnaires. Nineteen participants were interviewed at baseline and completion. Analysis of questionnaires demonstrated a significant increase in confidence using MHR and in self-reported frequency of MHR use, post-education compared with baseline. There were also similar improvements in confidence across the cohort pre-post education in deprescribing, frequency of review of pathology ordering regimens and evidence-based imaging. The qualitative findings showed an increase in GPs’ perceived capability with, and the use of MHR, at post-education compared with baseline. Participants saw the education as an opportunity for learning, for reinforcing what they already knew, and for motivating change of behaviour in increasing their utilisation of MHR, and ordering fewer unnecessary tests and prescriptions. Conclusions Our education intervention appeared to provide its effects through providing opportunity, increasing capability and enhancing motivation to increase MHR knowledge and usage, as well as rational prescribing and test ordering behaviour. There were overlapping effects of skills acquisition and confidence across intervention arms, which may have contributed to wider changes in behaviour than the specific topic area addressed in the education. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12620000010998) (09/01/2020).

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Identifying the key determinants of a community pharmacy based bladder and bowel service

Uren,

Watson,

Dawson

et al. 2024

Research in Social and Administrative Pharmacy

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Implementation of behaviour change training in practice amongst pharmacy professionals in primary care settings: Analysis using the COM-B model

Cited by 3 publications

References 28 publications

Integrating palliative care and heart failure: a systematic realist synthesis (PalliatHeartSynthesis)

Integrating palliative care and heart failure: a systematic realist synthesis (PalliatHeartSynthesis)

CHIME-GP trial of online education for prescribing, pathology and imaging ordering in general practice – how did it bring about behaviour change?

Identifying the key determinants of a community pharmacy based bladder and bowel service

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