Role congruence in pharmacists’ provision of weight loss advice to overweight patients with cardiovascular disease

Abstract

Background: Research suggests that pharmacists have low self-efficacy to facilitate patient lifestyle behaviour change. Our qualitative work identified that pharmacists felt less equipped to give patients with cardiovascular disease (CVD) weight loss advice than advice about medication adherence. The present study aimed to identify the theoretical predictors of UK pharmacists' intentions to give weight loss advice to overweight patients with CVD. Methods: A cross-sectional design was used. Questionnaires based on qualitative findings and a framework of health professional behaviour (an augmented version of the Theory of Planned Behaviour) were sent to a stratified sample of 1,200 community pharmacies in England. Findings: Questionnaires were returned by 231 participants. Pharmacists had lower intentions to give weight loss advice than medication adherence advice (p<0.001), and reported having given less weight loss advice than medication adherence advice in the past (p<0.001). Hierarchical regression models predicted 38.2% of the variance in intention to give weight loss advice. The strongest predictor was role congruence (pharmacists' perception of whether the behaviour was an important part of their role). Pharmacists perceived the provision of weight loss advice to overweight patients with CVD as less role congruent than giving medication adherence advice (p<0.001). Self-efficacy was not a predictor of intention to give weight loss or medication adherence advice once role congruency was included. Discussion: Role congruence was the strongest predictor of intention to give weight loss advice. The relationship between role congruence, self-efficacy and pharmacists’ provision of advice to patients merits further investigation in order to understand actual behaviour.