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Attitude
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Consensus of agreement regarding ATTITUDES toward responding to prescribing feedback (≥75% agree/strongly agree; ≥6 GPs were outliers)
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Reviewing patient prescribing was a positive thing to do for the patient.
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Reviewing patient prescribing gave GPs a sense of protecting their patients.
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The fear of a patient having a significant event as a result of receiving high-risk prescribing caused GPs concern.
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Reviewing patient prescribing was important.
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GPs do not regard receiving prescribing feedback as a criticism.
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GPs would not feel defensive in response to receiving prescribing feedback.
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There was disagreement among GP responses to the following statements (>25%; more than 6 GPs were outliers)
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Being seen by my colleagues to have unwittingly prescribed a high-risk drug would be embarrassing.
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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.
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Subjective norms
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Consensus of agreement regarding the importance of other groups and the importance of their opinions to GPs (≥75% agree/strongly agree)
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The groups of people most likely to approve of responding to prescribing feedback were the GMC, other GPs and practice pharmacists.
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Approval from patients and GPs within their own practice was most important, followed by approval from the GMC then the practice pharmacist.
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Perceived Behavioural Control (PCB)
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Consensus of agreement regarding the BARRIERS to respond to the prescribing feedback (≥75% agree/strongly agree)
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GPs would be less likely to respond to the prescribing feedback if clinical guidelines are unclear, or there is no sound evidence base.
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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.
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There was disagreement among GP responses to the following statements (>25%)
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I already have too much to do and would struggle to find time to review patients receiving high-risk prescribing.
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I will not respond to the prescribing feedback if it appears difficult, or it is not clear what I need to do.
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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.
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I find stopping medications more difficult if the medication was started in secondary care.
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Patient preferences are a key determinant for me when considering whether or not to change a patient’s medication.
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Consensus of agreement regarding FACILITATORS of responding to the prescribing feedback (≥75% agree/strongly agree)
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Prescribing feedback is more persuasive if the recommendations are in line with SIGN/NICE guidelines.
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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.
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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.
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GPs would be more likely to respond to the prescribing feedback if they could use the reviews as part of their annual appraisal.
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