Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel

Application of behavioural theories, models, and frameworks in pharmacy practice research based on published evidence: a scoping review

BACKGROUND

Pharmacy practice research often focuses on the design, implementation and evaluation of pharmacy services and interventions. The use of behavioural theory in intervention research allows understanding of interventions' mechanisms of action and are more likely to result in effective and sustained interventions.

AIM

To collate, summarise and categorise the reported behavioural frameworks, models and theories used in pharmacy practice research.

METHOD

PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and EBSCO (CINAHL PLUS, British Education index, ERIC) were systematically searched to capture all pharmacy practice articles that had reported the use of behavioural frameworks, theories, or models since inception of the database. Results were filtered to include articles published in English in pharmacy practice journals. Full-text screening and data extraction were independently performed by two reviewers. A narrative synthesis of the data was adopted. Studies were reviewed for alignment to the UK Medical Research Council (MRC) framework to identify in which phase(s) of the research that the theory/model/framework had been employed.

RESULTS

Fifty articles met the inclusion criteria; a trend indicating an increasing frequency of behavioural theory/frameworks/models within pharmacy practice research was identified; the most frequently reported were Theory of Planned Behaviour and Theoretical Domains Framework. Few studies provided explicit and comprehensive justification for adopting a specific theory/model/framework and description of how it underpinned the research was lacking. The majority were investigations exploring determinants of behaviours, or facilitators and barriers to implementing or delivering a wide range of pharmacy services and initiatives within a variety of clinical settings (aligned to Phase 1 UK MRC framework).

CONCLUSION

This review serves as a useful resource for future researchers to inform their investigations. Greater emphasis to adopt a systematic approach in the reporting of the use of behavioural theories/models/frameworks will benefit pharmacy practice research and will support researchers in utilizing behavioural theories/models/framework in aspects of pharmacy practice research beyond intervention development.

Comparative assessment of medication knowledge among ambulatory patients: A cross-sectional study in Nigeria

Background

Patient knowledge on medication is considered a critical aspect of medication self-management by the patient. Medication education and counseling is an important component of pharmaceutical care services.

Objective

This study was aimed at evaluating the impact of medication education and counseling services offered to ambulatory patients receiving care in a typical Nigerian healthcare setting on the patients' knowledge of their medication.

Methods

A cross sectional prospective study conducted at the outpatient pharmacy unit of University of Uyo Teaching Hospital, Nigeria. The patient population was divided into two arms: those who were yet to receive medication education/counseling - Arm 1, and those who had received medication education/counseling from the clinical pharmacist - Arm 2. A patient medication knowledge assessment questionnaire was used to assess patients' knowledge of their prescribed medication. Data obtained were analyzed using the IBM SPSS computer package version 25.0.

Results

Three hundred and ninety-one outpatients (196 in Arm-1 and 195 in Arm-2) participated in the study. There was a statistically significant difference in the mean medication knowledge score between patients in Arm-1 and those in Arm-2. Patients in Arm-2 had a statistically significant higher mean medication knowledge score than those in Arm-1 (5.228 versus 3.191; t = 10.152; P = 0.000).

Conclusion

Outpatients who received medication education and counseling from clinical pharmacists had better knowledge of their prescribed medications than those who were yet to receive this pharmaceutical intervention.