TPB constructs | Delphi questionnaire: results |
---|---|
Attitude | Consensus of agreement regarding ATTITUDES toward responding to prescribing feedback (≥75% agree/strongly agree; ≥6 GPs were outliers) |

Reviewing patient prescribing was a positive thing to do for the patient. | |

Reviewing patient prescribing gave GPs a sense of protecting their patients. | |

The fear of a patient having a significant event as a result of receiving high-risk prescribing caused GPs concern. | |

Reviewing patient prescribing was important. | |

GPs do not regard receiving prescribing feedback as a criticism. | |

GPs would not feel defensive in response to receiving prescribing feedback. | |
There was disagreement among GP responses to the following statements (>25%; more than 6 GPs were outliers) | |

Being seen by my colleagues to have unwittingly prescribed a high-risk drug would be embarrassing. | |

A negative event as a result of changing prescribing in the past would make me less likely to change or stop medications in the future. | |
Subjective norms | Consensus of agreement regarding the importance of other groups and the importance of their opinions to GPs (≥75% agree/strongly agree) |

The groups of people most likely to approve of responding to prescribing feedback were the GMC, other GPs and practice pharmacists. | |

Approval from patients and GPs within their own practice was most important, followed by approval from the GMC then the practice pharmacist. | |
Perceived Behavioural Control (PCB) | Consensus of agreement regarding the BARRIERS to respond to the prescribing feedback (≥75% agree/strongly agree) |

GPs would be less likely to respond to the prescribing feedback if clinical guidelines are unclear, or there is no sound evidence base. | |

A negative event as a result of changing prescribing in the past would make GPs less likely to change or stop patient’s medication in the future. | |
There was disagreement among GP responses to the following statements (>25%) | |

I already have too much to do and would struggle to find time to review patients receiving high-risk prescribing. | |

I will not respond to the prescribing feedback if it appears difficult, or it is not clear what I need to do. | |

Even when it is high risk, I find it difficult to change my patients prescribing when they feel fine and are having little or no side effects from their medication. | |

I find stopping medications more difficult if the medication was started in secondary care. | |

Patient preferences are a key determinant for me when considering whether or not to change a patient’s medication. | |
Consensus of agreement regarding FACILITATORS of responding to the prescribing feedback (≥75% agree/strongly agree) | |

Prescribing feedback is more persuasive if the recommendations are in line with SIGN/NICE guidelines. | |

The messenger is important, and GPs would be more likely to respond to the prescribing feedback that came from the practice pharmacist, a respected clinician or the Health Board. | |

GPs would be more likely to respond to the prescribing feedback knowing that they would be able to benchmark the performance of their practice against other practices. | |

GPs would be more likely to respond to the prescribing feedback if they could use the reviews as part of their annual appraisal. |