Background

In 2017, Oregon passed legislation that authorized pharmacists to autonomously prescribe specified medications or devices that were included on the Formulary and Protocol Compendia (FPC). Factors that impact pharmacists’ intention to prescribe from the FPC are not currently known.

Objectives

Identify factors that influence pharmacists' intention to prescribe.

Methods

The Theory of Planned Behavior (TPB) served as the framework. Three focus groups were conducted with Oregon pharmacists between May and June 2019 to elicit salient beliefs about prescribing related to TPB constructs, including attitudes, subjective norms, perceived behavioral control, and perceived obligation. Two investigators conducted a qualitative content analysis and reached agreement on names of categories during consensus meetings. A codebook was created after analysis of the first focus group and used to guide the remaining analysis. Participants reported background information and awareness of prescribing rules via a questionnaire; descriptive statistics were used to report background information and the prescribing awareness summary score.

Results

Thirteen participants had 14.1 ± 10.8 years of pharmacist experience. Most earned a Doctor of Pharmacy degree (84.6%) and worked in a community pharmacy setting (61.5%). The mean score on the awareness assessment was 6.3 ± 0.9 (7 = highest awareness). The majority (76.9%) had previous prescribing experience. Attitudes were found to be shaped by behavioral beliefs related to the impact of pharmacist prescribing on patient-centered care and on practice transformation. Normative beliefs were primarily driven by outside groups past experiences with pharmacists and pharmacies. Control beliefs included the following categories: operational readiness; the relationships between comfort, competence, and confidence; and Board of Pharmacy requirements.

Conclusions

TPB was useful for exploring pharmacists’ beliefs related to their intention to prescribe using the FPC. Determining the relative importance of these factors in a broader population will enable stakeholders to develop interventions to improve uptake of prescribing via the FPC.

中文翻译：

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药剂师打算根据新法规开处方

背景

2017 年，俄勒冈州通过了立法，授权药剂师自主开具处方和协议纲要 (FPC) 中包含的特定药物或设备。目前尚不清楚影响药剂师从 FPC 开具处方意图的因素。

目标

确定影响药剂师开药意向的因素。

方法

计划行为理论（TPB）作为框架。在 2019 年 5 月至 2019 年 6 月期间，与俄勒冈州药剂师进行了三个焦点小组，以引发关于与 TPB 结构相关的处方的显着信念，包括态度、主观规范、感知行为控制和感知义务。两名研究人员进行了定性内容分析，并在共识会议期间就类别名称达成了一致。在对第一个焦点小组进行分析后创建了一个密码本，用于指导剩余的分析。参与者通过问卷报告了背景信息和对处方规则的认识；描述性统计用于报告背景信息和处方意识总结分数。

结果

13 名参与者有 14.1 ± 10.8 年的药剂师经验。大多数人获得药学博士学位（84.6%）并在社区药房工作（61.5%）。意识评估的平均得分为 6.3 ± 0.9（7 = 最高意识）。大多数人（76.9%）有过处方经验。态度受到行为信念的影响，这些行为信念与药剂师处方对以患者为中心的护理和实践转变的影响有关。规范性信念主要是由外部团体过去在药剂师和药店的经验驱动的。控制信念包括以下几类：操作准备；舒适、能力和信心之间的关系；和药房委员会的要求。

结论

TPB 有助于探索药剂师与他们使用 FPC 开处方的意图相关的信念。确定这些因素在更广泛人群中的相对重要性将使利益相关者能够制定干预措施，以提高通过 FPC 处方的接受度。