Theoretical approaches in the development and evaluation of behaviour change interventions that improve clinicians’ antimicrobial prescribing: a systematic review.

Talkhan, Hend; Stewart, Derek; McIntosh, Trudi; Al Hail, Moza; Abdulrouf, Pallivalappila; Ziglam, Hisham; Cunningham, Scott

Abstract

Introduction: Antimicrobial resistance (AMR) and its threats have long been recognised. Many countries have developed antimicrobial stewardship programmes with strategies to optimise antimicrobial prescribing, minimise AMR and improve outcomes. There remains a need for behaviour change interventions at clinician level to promote appropriate prescribing practice. Objectives: The aim of this review was to critically appraise, synthesise and present the available evidence for theoretical approaches in the development and evaluation of behaviour change interventions that improve clinicians' antimicrobial prescribing. Methods: Eleven electronic databases and search engines were searched for peer-reviewed, English language studies investigating theoretically based behaviour change interventions that improve clinicians’ antimicrobial prescribing in any healthcare setting. The Theory Coding Scheme was utilised to evaluate the methods by which theories have been used. Clinical and methodological heterogeneity limited data synthesis. Results: The searches resulted in 4227 potentially relevant papers after duplicates removal. Screening of titles/abstracts led to retrieval and dual assessment of 38 full-text papers. Of those, 12 studies met the inclusion criteria and were included in the systematic review. Most of studies included were from the UK (n = 8) and most were published in 2012 (n = 3); none was published before 2008. The majority of studies were carried out in primary care settings (n = 10) targeting upper respiratory tract infections (n = 9). Theoretical approaches used to inform the design and choice of intervention varied across included studies. The most common included: Theory of Planned Behaviour, Social Cognitive Theory and Operant Learning Theory. Conclusion: This systematic review is the first to investigate theoretically based behaviour change interventions for antimicrobial prescribing. Only a small number of primary research studies involving theory in intervention development and evaluation were identified. There is a need for further research in this area.

Citation

TALKHAN, H., STEWART, D., MCINTOSH, T., AL HAIL, M., ABDOULROUF, P. ZIGLAM, H. and CUNNINGHAM, S. 2019. Theoretical approaches in the development and evaluation of behaviour change interventions that improve clinicians’ antimicrobial prescribing: a systematic review. Presented at the 5th International conference on prevention and infection control (ICPIC 2019), 10-13 September 2019, Geneva, Switzerland.

• Presentation Conference Type: Poster
• Conference Name: 5th International conference of prevention and infection control (ICPIC 2019)
• Start Date: Sep 10, 2019
• End Date: Sep 13, 2019
• Deposit Date: Nov 25, 2019
• Publicly Available Date: Jan 16, 2020
• Peer Reviewed: Peer Reviewed
• Keywords: Antimicrobial resistance (AMR); Stewardship programmes; Prescribing; Behaviour change; Prescribing practice
• Public URL: https://rgu-repository.worktribe.com/output/790805
• Additional Information: Abstracts from this conference have been published in Antimicrobial Resistance and Infection Control [online], 8(1). Available from: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0567-6