Exploring the impact of pharmacist-led feedback on prescribing behaviour: A qualitative study

M. Lloyd, Simon Watmough, S.V. O'Brien, N. Furlong, K. Hardy

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Abstract

Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To explore the impact of pharmacist-led feedback on prescribing behaviour. Methods Semi-structured interviews were conducted with doctors who had received prescribing error feedback. A topic guide was used to explore the type of error and what impact feedback was having on prescribing behaviour. All interviews were transcribed verbatim and analysed thematically using a framework approach. Results Twenty-three prescribers were interviewed and 65 errors discussed over 38 interviews. Key themes included; affective behaviour, learning outcome, prescribing behaviour and likelihood of error recurrence. Feedback was educational whilst a range of adaptive prescribing behaviours were also reported. Prescribers were more mindful and engaged with the prescribing process whilst feedback facilitated reflection, increased self-awareness and informed self-regulation. Greater information and feedback-seeking behaviours were reported whilst prescribers also reported greater situational awareness, and that they were making fewer prescribing errors following feedback. Conclusions Pharmacist-led feedback was perceived to positively influence prescribing behaviour. Reported changes in prescriber behaviour resonate with the non-technical skills (NTS) of prescribing with prescribers adapting their prescribing behaviour depending on the environment and prescribing conditions. A model of prescribing is proposed with NTS activated in response to error provoking conditions. These findings have implications for prescribing education to make it a more contextualised educational process.
Original languageEnglish
Pages (from-to)545-554
JournalResearch in Social & Administrative Pharmacy
Volume14
Issue number6
Early online date29 Jun 2018
DOIs
Publication statusPublished - 30 Jun 2018

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Pharmacists
Interviews
Information Seeking Behavior
Psychological Adaptation
Learning
Education
Recurrence

Cite this

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abstract = "Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To explore the impact of pharmacist-led feedback on prescribing behaviour. Methods Semi-structured interviews were conducted with doctors who had received prescribing error feedback. A topic guide was used to explore the type of error and what impact feedback was having on prescribing behaviour. All interviews were transcribed verbatim and analysed thematically using a framework approach. Results Twenty-three prescribers were interviewed and 65 errors discussed over 38 interviews. Key themes included; affective behaviour, learning outcome, prescribing behaviour and likelihood of error recurrence. Feedback was educational whilst a range of adaptive prescribing behaviours were also reported. Prescribers were more mindful and engaged with the prescribing process whilst feedback facilitated reflection, increased self-awareness and informed self-regulation. Greater information and feedback-seeking behaviours were reported whilst prescribers also reported greater situational awareness, and that they were making fewer prescribing errors following feedback. Conclusions Pharmacist-led feedback was perceived to positively influence prescribing behaviour. Reported changes in prescriber behaviour resonate with the non-technical skills (NTS) of prescribing with prescribers adapting their prescribing behaviour depending on the environment and prescribing conditions. A model of prescribing is proposed with NTS activated in response to error provoking conditions. These findings have implications for prescribing education to make it a more contextualised educational process.",
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Exploring the impact of pharmacist-led feedback on prescribing behaviour: A qualitative study. / Lloyd, M.; Watmough, Simon; O'Brien, S.V.; Furlong, N.; Hardy, K.

In: Research in Social & Administrative Pharmacy, Vol. 14, No. 6, 30.06.2018, p. 545-554.

Research output: Contribution to journalArticle

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N2 - Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To explore the impact of pharmacist-led feedback on prescribing behaviour. Methods Semi-structured interviews were conducted with doctors who had received prescribing error feedback. A topic guide was used to explore the type of error and what impact feedback was having on prescribing behaviour. All interviews were transcribed verbatim and analysed thematically using a framework approach. Results Twenty-three prescribers were interviewed and 65 errors discussed over 38 interviews. Key themes included; affective behaviour, learning outcome, prescribing behaviour and likelihood of error recurrence. Feedback was educational whilst a range of adaptive prescribing behaviours were also reported. Prescribers were more mindful and engaged with the prescribing process whilst feedback facilitated reflection, increased self-awareness and informed self-regulation. Greater information and feedback-seeking behaviours were reported whilst prescribers also reported greater situational awareness, and that they were making fewer prescribing errors following feedback. Conclusions Pharmacist-led feedback was perceived to positively influence prescribing behaviour. Reported changes in prescriber behaviour resonate with the non-technical skills (NTS) of prescribing with prescribers adapting their prescribing behaviour depending on the environment and prescribing conditions. A model of prescribing is proposed with NTS activated in response to error provoking conditions. These findings have implications for prescribing education to make it a more contextualised educational process.

AB - Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To explore the impact of pharmacist-led feedback on prescribing behaviour. Methods Semi-structured interviews were conducted with doctors who had received prescribing error feedback. A topic guide was used to explore the type of error and what impact feedback was having on prescribing behaviour. All interviews were transcribed verbatim and analysed thematically using a framework approach. Results Twenty-three prescribers were interviewed and 65 errors discussed over 38 interviews. Key themes included; affective behaviour, learning outcome, prescribing behaviour and likelihood of error recurrence. Feedback was educational whilst a range of adaptive prescribing behaviours were also reported. Prescribers were more mindful and engaged with the prescribing process whilst feedback facilitated reflection, increased self-awareness and informed self-regulation. Greater information and feedback-seeking behaviours were reported whilst prescribers also reported greater situational awareness, and that they were making fewer prescribing errors following feedback. Conclusions Pharmacist-led feedback was perceived to positively influence prescribing behaviour. Reported changes in prescriber behaviour resonate with the non-technical skills (NTS) of prescribing with prescribers adapting their prescribing behaviour depending on the environment and prescribing conditions. A model of prescribing is proposed with NTS activated in response to error provoking conditions. These findings have implications for prescribing education to make it a more contextualised educational process.

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