Investigating physicians' views on non-formulary prescribing: a qualitative study using the theoretical domains framework.

BACKGROUND: Well-designed and well-maintained drug formularies serve as a reliable resource to guide prescribing decisions; they are associated with improved medicine safety and increased efficiency, while also serving as a cost-effective tool to help manage and predict medicine expenditure. Multiple studies have investigated the inappropriate prescribing of non-formulary drugs (NFDs) with statistics indicating that up to 70% of NFD usage being inappropriate or not following the ascribed NFD policies. AIM: To explore physicians' views and influences on their prescribing of non-formulary drugs. METHOD: Data collection and analysis were underpinned using the Theoretical Domains Framework (TDF). Thirteen semi-structured interviews were conducted within Hamad Medical Corporation, the main provider of secondary and tertiary healthcare in Qatar, with physicians who had submitted a NFD request in the preceding 12 months. RESULTS: Three overarching themes were identified: providing evidence-based care for individual patients; influences of others; and formulary management issues. Subthemes were mapped to specific TDF domains: environmental context and resources; social influences; professional role and identity; beliefs about consequences; goals; intentions. CONCLUSION: The behavioral influences identified in this study can be mapped to behavior change strategies facilitating the development of an intervention to promote appropriate prescribing of NFDs with implications for medicine safety and healthcare efficiency.

Knowledge and attitude regarding coronavirus disease 2019 (COVID-19) among hospital pharmacists in Qatar.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gained global attention because of its high transmissibility and the devastating impact on both clinical and economic outcomes. Pharmacists are among the front-line healthcare workers who contributed widely to COVID-19 pandemic control. We aim to evaluate knowledge and attitude of hospital pharmacists in Qatar about COVID-19. Methods: A descriptive cross-sectional web-based survey was distributed over a 2-months period. The study included pharmacists who are working in 10 different hospitals under Hamad Medical Corporation (HMC). The survey was developed based on information available at World Health Organization (WHO) website, Qatar Ministry of Health, and COVID-19 guideline created by HMC. The study was approved by HMC's institutional review board (MRC-01-20-1009). Data analysis was done using SPSS version 22. Results: A total of 187 pharmacists were included (response rate 33%). The overall level of knowledge was not affected by the participants' demographics (p-value ≥0.05). Pharmacists provided more correct answers to questions related to general knowledge about COVID-19 compared to questions specificto treatment aspects of the disease. More than 50% of pharmacists were using national resources as main source of information related to COVID-19. Good health practices and attitudes regarding disease control was reported by pharmacists, including preventive measures implementation and self-isolation when needed. Around 80% of pharmacists are in favor of taking influenza vaccine and COVID-19 vaccine. Conclusion: Overall, hospital pharmacists' knowledge about COVID-19 is good in relation to the disease nature and transmission. Knowledge about treatment aspects including medications needs further enhancement. Providing continuing professional development activities regarding latest information about COVID-19 and its management, and serial newsletters updates, and encouraging journal club activities for recently published research can help improve hospital pharmacist knowledge.