• M Lloyd, S D Watmough, S V O'Brien, N Furlong, and K Hardy.
• Pharmacy Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK. Electronic address: Michael.lloyd@sthk.nhs.uk.
• Res Social Adm Pharm. 2018 Jun 1; 14 (6): 545-554.

BackgroundPrescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited.ObjectivesTo explore the impact of pharmacist-led feedback on prescribing behaviour.MethodsSemi-structured interviews were conducted with doctors who had received prescribing error feedback. A topic guide was used to explore the type of error and what impact feedback was having on prescribing behaviour. All interviews were transcribed verbatim and analysed thematically using a framework approach.ResultsTwenty-three prescribers were interviewed and 65 errors discussed over 38 interviews. Key themes included; affective behaviour, learning outcome, prescribing behaviour and likelihood of error recurrence. Feedback was educational whilst a range of adaptive prescribing behaviours were also reported. Prescribers were more mindful and engaged with the prescribing process whilst feedback facilitated reflection, increased self-awareness and informed self-regulation. Greater information and feedback-seeking behaviours were reported whilst prescribers also reported greater situational awareness, and that they were making fewer prescribing errors following feedback.ConclusionsPharmacist-led feedback was perceived to positively influence prescribing behaviour. Reported changes in prescriber behaviour resonate with the non-technical skills (NTS) of prescribing with prescribers adapting their prescribing behaviour depending on the environment and prescribing conditions. A model of prescribing is proposed with NTS activated in response to error provoking conditions. These findings have implications for prescribing education to make it a more contextualised educational process.Copyright © 2017 Elsevier Inc. All rights reserved.

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