Using the theory of planned behavior to predict Texas pharmacists' intention to report serious adverse drug events
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The purpose of this dissertation was to use the theory of planned behavior (TPB) to predict Texas pharmacists’ intention to report serious adverse drug effects (ADEs) to the Food and Drug Administration (FDA). The study explored the utility of the TPB model constructs (attitude [A], subjective norm [SN], perceived behavioral control [PBC]), as well as past reporting behavior (PRB), and perceived moral obligation (PMO) to predict pharmacists’ intention to report serious ADEs to the FDA. The study also determined if the pharmacists’ A, SN and PBC were related to practice characteristics and demographic factors. A survey was developed based on two focus group interviews, pretested and mailed to 1,500 Texas practicing pharmacists. An overall response rate of 26.4 percent was obtained (n = 377 pharmacists). Overall, pharmacists intended to report serious ADEs, had a favorable attitude towards reporting, were somewhat influenced by social norms regarding reporting and perceived themselves to have some control over reporting serious ADEs to the FDA. For direct measures, A and SN were significant predictors of intention to report serious ADEs, but PBC was not. The TPB constructs together accounted for 34.0 percent of the variance in intention to report serious ADEs to the FDA. Using indirect measures, A, SN and PBC were significant predictors of intention and together accounted for 28.8 percent of the variance in intention to report serious ADEs. PRB and PMO improved the explanatory power of the regression models (direct and indirect measures) over and above the TPB constructs. Unlike most other practice characteristics and demographic factors examined, knowledge was significantly related with the TPB constructs. In summary, A, SN, PBC (indirect measures), PRB, and PMO influence the formation of pharmacists’ intention to report serious ADEs. The TPB has utility in predicting ADE reporting behavior. Pharmacy educators should explore pharmacists’ attitudes, beliefs, and expectations of important others in designing educational programs. Strategies to help pharmacists report more serious ADEs should focus on altering their perception of social pressure towards reporting and addressing the barriers towards ADE reporting (e.g., lack of knowledge).