Using the theory of planned behavior to examine Texas community pharmacists’ intentions to utilize a prescription drug monitoring program
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The purpose of this study was to determine the predictive utility of the theory of planned behavior (TPB) in predicting and explaining pharmacists’ intention to utilize a prescription drug monitoring program (PDMP) database, when the validity of the prescription/patient need is in question. The study tested the significance of each TPB model construct variable (attitude [A], subjective norm [SN], and perceived behavioral control [PBC]) in predicting pharmacists’ high intention, compared to non-high intention (dichotomous variable). In addition, the study examined the additional contribution of pharmacists’ perception of prescription (PPDA) drug abuse and perceived obligation (PO) to the TPB model. Demographic and practice characteristics were also explored in relation to the TPB model predictors, A, SN and PBC. A mail questionnaire was sent to a random sample of 998 Texas community pharmacists with active licenses. Three focus groups were conducted to collect information regarding pharmacists’ beliefs toward PDMP database utilization. The usable survey response rate was 26.2%. Due to data that were not normally distributed, intention was dichotomized into high intention and non-high intention. The TPB constructs were significant predictors of pharmacists’ high intention. Pharmacists with positive attitudes were almost twice as likely to have high intention (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.2 – 2.8). However, SN was the strongest predictor of pharmacists’ high intention (OR = 2.2, 95% CI = 1.4 – 3.3). Pharmacists who reported substantial PBC were also twice as likely to have high intention (OR = 1.9, 95% CI = 1.2 – 3.0). PPDA was not significantly related to pharmacists’ high intention. However, pharmacists’ PO was shown to predict high intention above that explained by the TPB model (OR = 1.8, 95% CI = 1.0 – 3.1). The results of this study support the utility of the TPB model with PO in predicting pharmacists’ high intention to utilize a PDMP database. Interventions that address pharmacists’ A, SN, PBC, and PO may be necessary to increase pharmacists’ high intention to utilize a PDMP database when it becomes available. Future studies using intention as a predictor of pharmacists’ behavior are needed to assess the influence of intention on PDMP utilization.