Abstract
Objectives: This study aimed to establish a consensus on key factors that influence medication choices for Parkinson’s disease and to identify the behavioural determinants of these factors using behavioural change theory as a theoretical lens.
Design: This qualitative study used the nominal group technique to conduct structured online focus group meetings. A facilitator guided participants to (1) individually generate a list of factors that influence their decision to prescribe, (2) collectively share these factors, (3) refine and clarify factors and (4) rank the most important factors. Subsequently, the most important factors identified were mapped to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation–Behaviour (COM-B) model to identify the behavioural determinants that influence medication choice.
Participants: Eighteen healthcare professionals, including neurologists, consultants and specialist nurses/practitioners who prescribe medication, were recruited across Europe and participated in one of seven focus groups.
Results: There was good consensus among the participants about which factors influence their prescribing decisions. Overall, participants identified 60 unique factors that were broadly categorised into the following themes: medical or symptom concern, patient characteristics, side effects, access to treatment, clinical guidelines, social support and patient preference. Factors discussed and prioritised by the participants aligned with seven of the 14 TDF domains: knowledge; memory, attention and decision processes; beliefs about consequences; goals; social/professional role and identity; environment context and resources; and social influences. Together, these were subsequently mapped onto four of the six subdomains of the COM-B model: psychological capability, reflective motivation, physical opportunity and social opportunity.
Conclusions: These findings suggest that prescribing decisions for Parkinson’s disease are determined by a complex range of factors linked to the COM-B components capability, motivation and opportunity. These can be further understood by specific behavioural domains, as identified by the TDF, which should be targeted to help optimise subsequent prescribing decisions.
Design: This qualitative study used the nominal group technique to conduct structured online focus group meetings. A facilitator guided participants to (1) individually generate a list of factors that influence their decision to prescribe, (2) collectively share these factors, (3) refine and clarify factors and (4) rank the most important factors. Subsequently, the most important factors identified were mapped to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation–Behaviour (COM-B) model to identify the behavioural determinants that influence medication choice.
Participants: Eighteen healthcare professionals, including neurologists, consultants and specialist nurses/practitioners who prescribe medication, were recruited across Europe and participated in one of seven focus groups.
Results: There was good consensus among the participants about which factors influence their prescribing decisions. Overall, participants identified 60 unique factors that were broadly categorised into the following themes: medical or symptom concern, patient characteristics, side effects, access to treatment, clinical guidelines, social support and patient preference. Factors discussed and prioritised by the participants aligned with seven of the 14 TDF domains: knowledge; memory, attention and decision processes; beliefs about consequences; goals; social/professional role and identity; environment context and resources; and social influences. Together, these were subsequently mapped onto four of the six subdomains of the COM-B model: psychological capability, reflective motivation, physical opportunity and social opportunity.
Conclusions: These findings suggest that prescribing decisions for Parkinson’s disease are determined by a complex range of factors linked to the COM-B components capability, motivation and opportunity. These can be further understood by specific behavioural domains, as identified by the TDF, which should be targeted to help optimise subsequent prescribing decisions.
| Original language | English |
|---|---|
| Article number | e090018 |
| Number of pages | 9 |
| Journal | BMJ Open |
| Volume | 15 |
| Issue number | 2 |
| Early online date | 19 Feb 2025 |
| DOIs | |
| Publication status | Published - 19 Feb 2025 |
Bibliographical note
Copyright © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.Data Access Statement
All data relevant to the study are included in the article or uploaded as supplementary information. Due to the unique nature of thenominal group technique method, all data are included in the paper (table 1) and online supplemental file 2.
Keywords
- Adult
- Antiparkinson Agents/therapeutic use
- Attitude of Health Personnel
- Behavioral Sciences
- Choice Behavior
- Decision Making
- Europe
- Female
- Focus Groups
- Humans
- Male
- Middle Aged
- Motivation
- Parkinson Disease/drug therapy
- Patient Preference
- Practice Patterns, Physicians'
- Qualitative Research