Behaviour-change techniques in pharmacy interventions: systematic review identifying opportunities for increased effectiveness and improved reporting

Abstract

Background Behaviour change interventions are used by many healthcare professionals and increasingly by pharmacists, enabling them to change patient behaviours including medication management and health promotion e.g. smoking cessation. The aim of this study was to describe the Behaviour Change Techniques (BCTs) in pharmacists’ interventions. Methods Interventions delivered in randomised controlled trials identified in a Cochrane systematic review of outpatient pharmacists’ non-dispensing roles were independently coded by two coders for BCTs using the BCTT Taxonomy (BCTTv1). Findings In total, 87 RCTs were identified and interventions coded. For 18 studies no BCTs were reported. In the remaining 69 studies, 26 BCTs were identified and, the average number of BCTs was 3, with a range from 1 to 10. The most common BCTs were ‘Information about health consequences’, ‘Instruction on how to perform the behaviour’, ‘Social support (practical)’, ‘Social support (unspecified)’ and ‘Problem solving’. Discussion A large number of trials reported no identifiable BCTs but many had significant effects on behaviour. This suggests that the intervention has been inadequately reported and would therefore be difficult to replicate. Whilst several BCTs were used frequently, many BCTs have not been included in pharmacy interventions, including at least 15 which are commonly used in other behaviour change trials and which might be applicable in pharmacy practice. In conclusion, there are opportunities for enhancing the effectiveness of pharmacy interventions and for improving clarity and completeness of reporting the interventions.