Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.

Hdl Handle:
http://hdl.handle.net/10147/336272
Title:
Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.
Authors:
Cullinan, S; Fleming, A; O'Mahony, D; Ryan, C; O'Sullivan, D; Gallagher, P; Byrne, S
Affiliation:
Cavanagh Pharmacy Building, College Road, Cork, Ireland.
Citation:
Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study. 2014: Br J Clin Pharmacol
Publisher:
British journal of clinical pharmacology
Journal:
British journal of clinical pharmacology
Issue Date:
18-Nov-2014
URI:
http://hdl.handle.net/10147/336272
DOI:
10.1111/bcp.12555
PubMed ID:
25403269
Abstract:
Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.; Semi-structured interviews based on the Theoretical Domains Framework (TDF), a tool used to apply behaviour change theories, were conducted with 22 hospital doctors. Content analysis was conducted to identify domains of the TDF that could be targeted to improve prescribing for older people. These domains were then mapped to the behaviour change wheel to identify possible intervention types.; Content analysis identified 5 of the 12 domains in the TDF as relevant; (1) environmental context and resources, (2) knowledge, (3) skills, (4) social influences and (5) memory/attention and decision processes. Using the behaviour change wheel, the types of interventions deemed suitable were those based on training and environmental restructuring.; This study show that doctors feel there is insufficient emphasis on geriatric pharmacotherapy in their undergraduate/postgraduate training. An intervention providing supplementary training, with particular emphasis on decision processes and dealing with social influences would be justified. This study has however, uncovered many areas for potential intervention in the future.
Item Type:
Article
Language:
en
Description:
AIMS: Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing. METHODS: Semi-structured interviews based on the Theoretical Domains Framework (TDF), a tool used to apply behaviour change theories, were conducted with 22 hospital doctors. Content analysis was conducted to identify domains of the TDF that could be targeted to improve prescribing for older people. These domains were then mapped to the behaviour change wheel to identify possible intervention types. RESULTS: Content analysis identified 5 of the 12 domains in the TDF as relevant; (1) environmental context and resources, (2) knowledge, (3) skills, (4) social influences and (5) memory/attention and decision processes. Using the behaviour change wheel, the types of interventions deemed suitable were those based on training and environmental restructuring. CONCLUSION: This study show that doctors feel there is insufficient emphasis on geriatric pharmacotherapy in their undergraduate/postgraduate training. An intervention providing supplementary training, with particular emphasis on decision processes and dealing with social influences would be justified. This study has however, uncovered many areas for potential intervention in the future.
Keywords:
MEDICATION MANAGEMENT; OLDER PEOPLE; HOSPITAL
ISSN:
1365-2125

Full metadata record

DC FieldValue Language
dc.contributor.authorCullinan, Sen_GB
dc.contributor.authorFleming, Aen_GB
dc.contributor.authorO'Mahony, Den_GB
dc.contributor.authorRyan, Cen_GB
dc.contributor.authorO'Sullivan, Den_GB
dc.contributor.authorGallagher, Pen_GB
dc.contributor.authorByrne, Sen_GB
dc.date.accessioned2014-11-27T14:37:26Z-
dc.date.available2014-11-27T14:37:26Z-
dc.date.issued2014-11-18-
dc.identifier.citationDoctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study. 2014: Br J Clin Pharmacolen_GB
dc.identifier.issn1365-2125-
dc.identifier.pmid25403269-
dc.identifier.doi10.1111/bcp.12555-
dc.identifier.urihttp://hdl.handle.net/10147/336272-
dc.descriptionAIMS: Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing. METHODS: Semi-structured interviews based on the Theoretical Domains Framework (TDF), a tool used to apply behaviour change theories, were conducted with 22 hospital doctors. Content analysis was conducted to identify domains of the TDF that could be targeted to improve prescribing for older people. These domains were then mapped to the behaviour change wheel to identify possible intervention types. RESULTS: Content analysis identified 5 of the 12 domains in the TDF as relevant; (1) environmental context and resources, (2) knowledge, (3) skills, (4) social influences and (5) memory/attention and decision processes. Using the behaviour change wheel, the types of interventions deemed suitable were those based on training and environmental restructuring. CONCLUSION: This study show that doctors feel there is insufficient emphasis on geriatric pharmacotherapy in their undergraduate/postgraduate training. An intervention providing supplementary training, with particular emphasis on decision processes and dealing with social influences would be justified. This study has however, uncovered many areas for potential intervention in the future.en_GB
dc.description.abstractOlder patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.-
dc.description.abstractSemi-structured interviews based on the Theoretical Domains Framework (TDF), a tool used to apply behaviour change theories, were conducted with 22 hospital doctors. Content analysis was conducted to identify domains of the TDF that could be targeted to improve prescribing for older people. These domains were then mapped to the behaviour change wheel to identify possible intervention types.-
dc.description.abstractContent analysis identified 5 of the 12 domains in the TDF as relevant; (1) environmental context and resources, (2) knowledge, (3) skills, (4) social influences and (5) memory/attention and decision processes. Using the behaviour change wheel, the types of interventions deemed suitable were those based on training and environmental restructuring.-
dc.description.abstractThis study show that doctors feel there is insufficient emphasis on geriatric pharmacotherapy in their undergraduate/postgraduate training. An intervention providing supplementary training, with particular emphasis on decision processes and dealing with social influences would be justified. This study has however, uncovered many areas for potential intervention in the future.-
dc.languageENG-
dc.language.isoenen
dc.publisherBritish journal of clinical pharmacologyen_GB
dc.rightsArchived with thanks to British journal of clinical pharmacologyen_GB
dc.subjectMEDICATION MANAGEMENTen_GB
dc.subjectOLDER PEOPLEen_GB
dc.subjectHOSPITALen_GB
dc.titleDoctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.en_GB
dc.typeArticleen
dc.contributor.departmentCavanagh Pharmacy Building, College Road, Cork, Ireland.en_GB
dc.identifier.journalBritish journal of clinical pharmacologyen_GB

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