Increased self-reported pharmacist prescribing during the COVID-19 pandemic: Using the Theoretical Domains Framework to identify barriers and facilitators to prescribing

Grant, Amy; Rowe, Liam; Kennie‐Kaulbach, Natalie; Bishop, Alex; Kontak, Julia; Stewart, Samuel Alan; Morrison, Bobbi; Sketris, Ingrid; Rodrigues, Glenn; Minard, Laura V.; Whelan, Anne Marie; Woodill, Lisa; Jeffers, Elizabeth; Fisher, Judith; Ricketts, Juanna; Isenor, Jennifer E.

doi:10.1016/j.sapharm.2022.08.014

Cited by 4 publications

(3 citation statements)

References 54 publications

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“…Previous studies have noted the community environment as a top barrier to prescribing, particularly during the pandemic. 36-41 The environmental context has further been highlighted as a barrier for community pharmacists to provide quality of care to complex people with CKD. 42-47…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have noted the community environment as a top barrier to prescribing, particularly during the pandemic. [36][37][38][39][40][41] The environmental context has further been highlighted as a barrier for community pharmacists to provide quality of care to complex people with CKD. [42][43][44][45][46][47] Pharmacists in this study were not always aware that people had advanced CKD or were on dialysis.…”

Section: Discussionmentioning

confidence: 99%

“…45 In a recent study in Nova Scotia, self-reported prescribing by community pharmacists significantly increased when a diagnosis was supported by a protocol. 38 Having a protocol (or tool) to support community pharmacists in adapting prescriptions could mitigate inappropriate drug exposure and subsequent adverse outcomes. Optimal drug tool content and format, education and training were provided by participants as enablers for a CKD tool.…”

Section: Discussionmentioning

confidence: 99%

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Community pharmacists’ perspectives on assessing kidney function and medication dosing for patients with advanced chronic kidney disease: A qualitative study using the theoretical domains framework

Tran,

Shaffelburg,

Phelan

et al. 2023

Can Pharm J

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Background: The kidneys are responsible for the elimination of many drugs. Chronic kidney disease (CKD) is common, and medications may require adjustment to avoid adverse outcomes. Despite the availability of kidney drug dosing resources, people with CKD are at risk of inappropriate drug prescribing. Community pharmacists are in the ideal position to mitigate harm from inappropriate prescribing in this population. Methods: In this qualitative study, community pharmacists were interviewed on their perspective on kidney function assessment and dose adjustment in people with advanced CKD (estimated glomerular filtration rate <30 mL/min/1.73 m2). The theoretical domains framework for targeting behavioural change was used to inform the interview guide and analysis. Purposeful sampling was employed until data saturation. Semistructured virtual interviews were audio-recorded, transcribed verbatim and uploaded into NVIVO 12 Pro to facilitate thematic analysis. Deductive and inductive iterative coding approaches were employed to determine categories and themes. Results: Twelve pharmacists were interviewed, with a mean age of 42 years and 16 years of experience. Four themes comprising 10 categories were identified to influence kidney function assessment and dosing, including resources (information access, technology, references), environment (pharmacy infrastructure, practice setting), reflection (triggers, experience and training, collaboration) and leadership and governance (pharmacist role, advocacy). Feedback on an optimal CKD tool was collected, and enabling themes (categories) for implementation included knowledge and skills (education, training) and reflection (role, support, integration). Conclusions: Findings will inform the interventions needed to improve implementation of kidney assessment and dosing of high-risk medications in people with kidney impairment into community pharmacy practice. Can Pharm J (Ott) 2023;156:xx-xx.

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