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General Practitioners’ Intentions and Prescribing for Asthma: Using the Theory of Planned Behavior to Explain Guideline Implementation
Abstract
Objectives: Limited studies have demonstrated that the Theory
of Planned Behavior (TPB) may be able to help in explaining the variation in physicians’ behavior. We selected the management of asthma as the tracer topic because asthma had nationally known clinical guidelines, and the main medicinal therapies used for asthma had limited applications for the treatment of other diseases, and hence, it was possible to trace the relevant prescribing from routine data. In this study we used the TPB to explain general practitioners (GPs) intentions and prescribing in accordance with asthma clinical guidelines.
Methods: We surveyed a stratified random sample of 122 GPs
in England. The GPs demographic and prescribing data were
obtained from routine sources. The participants completed a TPB
questionnaire that was developed based on qualitative interviews and had been tested in a pilot study. Regression methods were utilized for data analysis.
Results: Forty‑three percent of variance in prescribing intentions
was explained by direct TPB measures. Perceived controls were the main predictors of variation in intentions. TPB belief item variables contributed to regression analysis that explained up to 34% of variation in the efficiency prescribing indicators. Effective prescribing indicators were unrelated to TPB variables.
Conclusions: Using TPB was helpful in understanding the
prescribing intentions of GPs. This could help in promoting the
prophylactic usage of inhaler corticosteroids and prevent chronic
asthma symptoms and side‑effects. However, further empirical
and methodological researches are required.
Keywords: Asthma, prevention, control, guideline adherence,
primary care physician
of Planned Behavior (TPB) may be able to help in explaining the variation in physicians’ behavior. We selected the management of asthma as the tracer topic because asthma had nationally known clinical guidelines, and the main medicinal therapies used for asthma had limited applications for the treatment of other diseases, and hence, it was possible to trace the relevant prescribing from routine data. In this study we used the TPB to explain general practitioners (GPs) intentions and prescribing in accordance with asthma clinical guidelines.
Methods: We surveyed a stratified random sample of 122 GPs
in England. The GPs demographic and prescribing data were
obtained from routine sources. The participants completed a TPB
questionnaire that was developed based on qualitative interviews and had been tested in a pilot study. Regression methods were utilized for data analysis.
Results: Forty‑three percent of variance in prescribing intentions
was explained by direct TPB measures. Perceived controls were the main predictors of variation in intentions. TPB belief item variables contributed to regression analysis that explained up to 34% of variation in the efficiency prescribing indicators. Effective prescribing indicators were unrelated to TPB variables.
Conclusions: Using TPB was helpful in understanding the
prescribing intentions of GPs. This could help in promoting the
prophylactic usage of inhaler corticosteroids and prevent chronic
asthma symptoms and side‑effects. However, further empirical
and methodological researches are required.
Keywords: Asthma, prevention, control, guideline adherence,
primary care physician