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Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel

BACKGROUND: Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivati...

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Autores principales: Abdu-Aguye, Samirah N., Mohammed, Shafiu, Danjuma, Nuhu M., Labaran, Kamilu S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centro de Investigaciones y Publicaciones Farmaceuticas 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216706/
https://www.ncbi.nlm.nih.gov/pubmed/34221193
http://dx.doi.org/10.18549/PharmPract.2021.2.2271
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author Abdu-Aguye, Samirah N.
Mohammed, Shafiu
Danjuma, Nuhu M.
Labaran, Kamilu S.
author_facet Abdu-Aguye, Samirah N.
Mohammed, Shafiu
Danjuma, Nuhu M.
Labaran, Kamilu S.
author_sort Abdu-Aguye, Samirah N.
collection PubMed
description BACKGROUND: Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivation behavior model (COM-B) or Theoretical Domains Framework (TDF) as a basis for identifying evidence-based intervention strategies to improve medication counselling. OBJECTIVE: To understand barriers/facilitators to optimal medication counselling by conducting a behavioral analysis using the COM-B model and TDF, and use the Behavior Change Wheel (BCW) as a basis for identifying evidence-based intervention strategies and policy categories that could be used to improve outpatient medication counselling by pharmacy staff in hospital settings located within Northwest Nigeria. METHODS: Semi-structured interviews were used to collect data from 25 purposively sampled pharmacy staff working at eight major public hospitals, from January till March 2020. Data from the interviews were then transcribed and deductively coded using the COM-B model and TDF. These findings were then used to identify areas requiring change, as well as the intervention type and policy functions required to support these changes. RESULTS: Findings from the behavioral analysis revealed shortfalls in pharmacy staff capability, opportunity and motivation with respect to outpatient medication counselling. To improve their counselling behaviors, change was identified as necessary in eight TDF domains namely ‘knowledge’, ‘interpersonal skills’, ‘memory’ ‘environmental context’, ‘social influences’, ‘intentions’, ‘reinforcement’ and ‘beliefs about capabilities’. Seven intervention functions including ‘education’, ‘training’, ‘modelling’, ‘enablement’ and ‘environmental restructuring’, in addition to three policy categories (‘guidelines’, ‘regulations’ and ‘environmental/social planning’) were also identified as relevant to future intervention design. CONCLUSIONS: Various factors were identified as affecting medication counselling by the pharmacy staff, with several of them requiring changes if counselling was to be improved upon. Multi-component interventions combining several of these intervention functions are recommended for hospital authorities and other relevant stakeholders to improve outpatient medication counselling.
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spelling pubmed-82167062021-07-01 Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel Abdu-Aguye, Samirah N. Mohammed, Shafiu Danjuma, Nuhu M. Labaran, Kamilu S. Pharm Pract (Granada) Original Research BACKGROUND: Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivation behavior model (COM-B) or Theoretical Domains Framework (TDF) as a basis for identifying evidence-based intervention strategies to improve medication counselling. OBJECTIVE: To understand barriers/facilitators to optimal medication counselling by conducting a behavioral analysis using the COM-B model and TDF, and use the Behavior Change Wheel (BCW) as a basis for identifying evidence-based intervention strategies and policy categories that could be used to improve outpatient medication counselling by pharmacy staff in hospital settings located within Northwest Nigeria. METHODS: Semi-structured interviews were used to collect data from 25 purposively sampled pharmacy staff working at eight major public hospitals, from January till March 2020. Data from the interviews were then transcribed and deductively coded using the COM-B model and TDF. These findings were then used to identify areas requiring change, as well as the intervention type and policy functions required to support these changes. RESULTS: Findings from the behavioral analysis revealed shortfalls in pharmacy staff capability, opportunity and motivation with respect to outpatient medication counselling. To improve their counselling behaviors, change was identified as necessary in eight TDF domains namely ‘knowledge’, ‘interpersonal skills’, ‘memory’ ‘environmental context’, ‘social influences’, ‘intentions’, ‘reinforcement’ and ‘beliefs about capabilities’. Seven intervention functions including ‘education’, ‘training’, ‘modelling’, ‘enablement’ and ‘environmental restructuring’, in addition to three policy categories (‘guidelines’, ‘regulations’ and ‘environmental/social planning’) were also identified as relevant to future intervention design. CONCLUSIONS: Various factors were identified as affecting medication counselling by the pharmacy staff, with several of them requiring changes if counselling was to be improved upon. Multi-component interventions combining several of these intervention functions are recommended for hospital authorities and other relevant stakeholders to improve outpatient medication counselling. Centro de Investigaciones y Publicaciones Farmaceuticas 2021 2021-05-24 /pmc/articles/PMC8216706/ /pubmed/34221193 http://dx.doi.org/10.18549/PharmPract.2021.2.2271 Text en Copyright: © The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Abdu-Aguye, Samirah N.
Mohammed, Shafiu
Danjuma, Nuhu M.
Labaran, Kamilu S.
Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title_full Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title_fullStr Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title_full_unstemmed Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title_short Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
title_sort improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216706/
https://www.ncbi.nlm.nih.gov/pubmed/34221193
http://dx.doi.org/10.18549/PharmPract.2021.2.2271
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