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Investigating physicians’ views on non-formulary prescribing: a qualitative study using the theoretical domains framework

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submitted on 2024-01-03, 07:38 and posted on 2024-01-03, 07:42 authored by Zachariah Nazar, Moza Al Hail, Samaher Al-Shaibi, Tarteel Ali Hussain, Nada Nabil Abdelkader, Abdulrouf Pallivalapila, Binny Thomas, Wessam El Kassem, Yolande Hanssens, Ahmed Mahfouz, Cristin Ryan, Derek Stewart

Background

Well-designed and well-maintained drug formularies serve as a reliable resource to guide prescribing decisions; they are associated with improved medicine safety and increased efficiency, while also serving as a cost-effective tool to help manage and predict medicine expenditure. Multiple studies have investigated the inappropriate prescribing of non-formulary drugs (NFDs) with statistics indicating that up to 70% of NFD usage being inappropriate or not following the ascribed NFD policies.

Aim

To explore physicians’ views and influences on their prescribing of non-formulary drugs.

Method

Data collection and analysis were underpinned using the Theoretical Domains Framework (TDF). Thirteen semi-structured interviews were conducted within Hamad Medical Corporation, the main provider of secondary and tertiary healthcare in Qatar, with physicians who had submitted a NFD request in the preceding 12 months.

Results

Three overarching themes were identified: providing evidence-based care for individual patients; influences of others; and formulary management issues. Subthemes were mapped to specific TDF domains: environmental context and resources; social influences; professional role and identity; beliefs about consequences; goals; intentions.

Conclusion

The behavioral influences identified in this study can be mapped to behavior change strategies facilitating the development of an intervention to promote appropriate prescribing of NFDs with implications for medicine safety and healthcare efficiency.

Other Information

Published in: International Journal of Clinical Pharmacy
License: https://creativecommons.org/licenses/by/4.0
See article on publisher's website: https://dx.doi.org/10.1007/s11096-023-01616-7

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

Springer Nature

Publication Year

  • 2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Qatar University
  • College of Pharmacy - QU HEALTH
  • Hamad Medical Corporation
  • Women's Wellness and Research Center - HMC

Methodology

Data collection and analysis were underpinned using the Theoretical Domains Framework (TDF). Thirteen semi-structured interviews were conducted within Hamad Medical Corporation, the main provider of secondary and tertiary healthcare in Qatar, with physicians who had submitted a NFD request in the preceding 12 months.