Understanding influences on the use of professional practice guidelines by pharmacists: A qualitative application of the COM-B model of behaviour

Background
Pharmacy practice in Australia is guided by professional practice guidelines. The guidelines communicate expected pharmacist behaviours to facilitate a consistently high standard of patient care, but are infrequently used by pharmacists and students. It is therefore essential to understand what influences pharmacists’ use of professional practice guidelines and how best to support positive behaviour change towards utilising these guidelines.

Objective
To explore perceived influences on the use of professional practice guidelines by Australian pharmacists, and to map these influences to the COM-B model of behaviour.

Method
Focus group discussions were undertaken with pharmacists (including intern pharmacists) from various practice settings, locations, and with varying years of experience. Audio-recordings from each focus group were de-identified and transcribed verbatim. Transcripts were analysed using the COM-B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model.

Results
Nine focus groups with 45 participants were conducted. Limited awareness of professional practice guidelines hindered pharmacists' ‘capability’ to use them. Pharmacists indicated that challenges accessing, and suboptimal content design, limited their ‘opportunity’ to use the guidelines. Pharmacists' professional role and identity (‘motivation’) appeared to inhibit use of the guidelines if they were perceived to not apply to their current role, or if pharmacists believed their experience obviated the need to use them. Motivation to use professional practice guidelines was associated with a belief that the guideline(s) would support pharmacists in their practice.

Conclusion(s)
Understanding what influences the use of professional practice guidelines should inform interventions to target and improve pharmacists’ use of the guidelines. The Behaviour Change Wheel offers clear next steps for this process. Awareness, access, and content could be improved in the first instance, and this may also work to improve motivation. Leveraging influences on motivation may serve to ensure that use of professional practice guidelines is embedded in future practice, albeit motivation can be more difficult to target.