The use of theory in the development and evaluation of behaviour change interventions to improve antimicrobial prescribing: a systematic review.

Talkhan, Hend; Stewart, Derek; McIntosh, Trudi; Ziglam, Hisham; Abdulrouf, Palli Valappila; Al-Hail, Moza; Diab, Mohammad; Cunningham, Scott

Abstract

Objectives: This systematic review (SR) reviews the evidence on use of theory in developing and evaluating behaviour change interventions (BCIs) to improve clinicians antimicrobial prescribing (AP). Methods: The SR protocol was registered with PROSPERO. Eleven databases were searched from inception to October 2018 for peer-reviewed, English-language, primary literature in any healthcare setting and for any medical condition. This included research on changing behavioural intentions (e.g. in simulated scenarios) and research measuring actual AP. All study designs/methodologies were included. Excluded were: grey literature and/or those which did not state a theory. Two reviewers independently extracted and quality assessed the data. The Theory Coding Scheme (TCS) evaluated the extent of the use of theory. Results: Searches found 4227 potentially relevant papers after removal of duplicates. Screening of titles/ abstracts led to dual assessment of 38 full-text papers. Ten (five quantitative, three qualitative and two mixedmethods) met the inclusion criteria. Studies were conducted in the UK (n = 8), Canada (n = 1) and Sweden (n = 1), most in primary care settings (n = 9), targeting respiratory tract infections (n = 8), and medical doctors (n = 10). The most common theories used were Theory of Planned Behaviour (n = 7), Social Cognitive Theory (n = 5) and Operant Learning Theory (n = 5). The use of theory to inform the design and choice of intervention varied, with no optimal use as recommended in the TCS. Conclusions: This SR is the first to investigate theoretically based BCIs around AP. Few studies were identified; most were suboptimal in theory use. There is a need to consider how theory is used and reported and the systematic use of the TCS could help.

Citation

TALKHAN, H., STEWART, D., MCINTOSH, T., ZIGLAM, H., ABDULROUF, P.V., AL-HAIL, M., DIAB, M. and CUNNINGHAM, S. 2020. The use of theory in the development and evaluation of behaviour change interventions to improve antimicrobial prescribing: a systematic review. Journal of antimicrobial chemotherapy [online], 75(9), pages 2394-2410. Available from: https://doi.org/10.1093/jac/dkaa154

• Journal Article Type: Review
• Acceptance Date: Mar 27, 2020
• Online Publication Date: May 1, 2020
• Publication Date: Sep 30, 2020
• Deposit Date: Jul 16, 2020
• Publicly Available Date: May 2, 2021
• Journal: Journal of antimicrobial chemotherapy
• Print ISSN: 0305-7453
• Electronic ISSN: 1460-2091
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 75
• Issue: 9
• Pages: 2394-2410
• DOI: https://doi.org/10.1093/jac/dkaa154
• Keywords: Antimicrobial prescribing; Behaviour change; Medical interventions; Theoretical models; Praxis
• Public URL: https://rgu-repository.worktribe.com/output/947587