dc.contributor.author | Reeve, J | |
dc.contributor.author | Britten, N | |
dc.contributor.author | Byng, R | |
dc.contributor.author | Fleming, J | |
dc.contributor.author | Heaton, J | |
dc.contributor.author | Krska, J | |
dc.date.accessioned | 2018-01-22T08:35:24Z | |
dc.date.issued | 2018-01-15 | |
dc.description.abstract | Background
Many people now take multiple medications on a long-term basis to manage health conditions. Optimising the benefit of such polypharmacy requires tailoring of medicines use to the needs and circumstances of individuals. However, professionals report barriers to achieving this in practice. In this study, we examined health professionals’ perceptions of enablers and barriers to delivering individually tailored prescribing.
Methods
Normalisation Process Theory (NPT) informed an on-line survey of health professionals’ views of enablers and barriers to implementation of Individually Tailored Prescribing (ITP) of medicines. Links to the survey were sent out through known professional networks using a convenience/snowball sampling approach. Survey questions sought to identify perceptions of supports/barriers for ITP within the four domains of work described by NPT: sense making, engagement, action and monitoring. Analysis followed the framework approach developed in our previous work.
Results
Four hundred and nineteen responses were included in the final analysis (67.3% female, 32.7% male; 52.7% nurse prescribers, 19.8% pharmacists and 21.8% GPs). Almost half (44.9%) were experienced practitioners (16+ years in practice); around one third reported already routinely offering ITP to their patients. GPs were the group least likely to recognise this as consistent usual practice. Findings revealed general support for the principles of ITP but significant variation and inconsistency in understanding and implementation in practice. Our findings reveal four key implications for practice: the need to raise understanding of ITP as a legitimate part of professional practice; to prioritise the work of ITP within the range of individual professional activity; to improve the consistency of training and support for interpretive practice; and to review the impact of formal and informal monitoring processes on practice.
Conclusion
The findings will inform the ongoing development of our new complex intervention (PRIME Prescribing) to support the individual tailoring of medicines needed to address problematic polypharmacy. | en_GB |
dc.identifier.citation | Vol. 19, pp. 1 - 13 | en_GB |
dc.identifier.doi | 10.1186/s12875-017-0705-2 | |
dc.identifier.uri | http://hdl.handle.net/10871/31123 | |
dc.language.iso | en | en_GB |
dc.publisher | BioMed Central | en_GB |
dc.rights | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en_GB |
dc.subject | Polypharmacy | en_GB |
dc.subject | Medicines optimisation | en_GB |
dc.subject | Individually tailored care | en_GB |
dc.title | Identifying enablers and barriers to individually tailored prescribing: a survey of healthcare professionals in the UK | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2018-01-22T08:35:24Z | |
dc.identifier.issn | 1471-2296 | |
dc.description | This is the final version of the article. Available from BioMed Central via the DOI in this record. | en_GB |
dc.identifier.journal | BMC Family Practice | en_GB |