Behavioural analysis of factors influencing prescribing for neurodegenerative diseases: a rapid review

Abstract

Background The incidence and prevalence of neurodegenerative diseases (NDs) are growing worldwide. In an environment where healthcare resources are already stretched, it is important to optimise treatment choice to help alleviate healthcare burden. This rapid review aims to consolidate evidence on factors that influence healthcare professionals (HCPs) to prescribe medication for NDs and map them to theoretical models of behaviour change to identify the behavioural determinants that may support in optimising prescribing. Methods and findings Embase and Ovid MEDLINE were used to identify relevant empirical research studies. Screening, data extraction and quality assessment were carried out by three independent reviewers to ensure consistency. Factors influencing prescribing were mapped to the Theoretical Domains Framework (TDF) and key behavioural determinants were described using the Capability, Opportunity, Motivation – Behaviour (COM-B) model. An initial 3,099 articles were identified, of which 53 were included for data extraction. Fifty-six factors influencing prescribing were identified and categorised into patient, HCP or healthcare system groups, then mapped to TDF and COM-B domains. Prescribing was influenced by capability of HCPs, namely factors mapped to decision making (e.g., patient age or symptom burden) and knowledge (e.g., clinical understanding) behavioural domains. However, most factors were influenced by HCP opportunity, underpinned by factors mapped to social (e.g., prescribing support or culture) and contextual (e.g., lack of resources or medication availability) domains. Less evidence was available on factors influencing the motivation of HCPs, where evident; factors primarily related to HCP belief about consequences (e.g., side effects) and professional identify (e.g., level of specialism) were often described. Conclusions This systematic analysis of the literature provides an in-depth understanding of the behavioural determinants that may support in optimising prescribing practices (e.g., drug costs or pressure from patients’ family members). Understanding these approaches provides an opportunity to identify relevant intervention functions and behaviour change techniques to target the factors that directly influence HCP prescribing behaviour.

Publication DOI: https://doi.org/10.1371/journal.pone.0322324
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences
College of Health & Life Sciences > Clinical and Systems Neuroscience
Aston University (General)
Funding Information: The funding for this work was awarded to CS and JT through an Innovate UK Knowledge Transfer Partnership (KTP) grant (ref 10011439, KTP number 13031) in partnership with Alpharmaxim Healthcare Communications (https://alpharmaxim.com/). KTPs are funded by
Additional Information: Copyright © 2025 Begley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publication ISSN: 1932-6203
Last Modified: 09 May 2025 07:14
Date Deposited: 07 May 2025 14:43
Full Text Link:
Related URLs: https://journal ... al.pone.0322324 (Publisher URL)
PURE Output Type: Article
Published Date: 2025-05-06
Accepted Date: 2025-03-18
Authors: Begley, Emma
Thomas, Jason (ORCID Profile 0000-0001-7013-8994)
Senior, Carl (ORCID Profile 0000-0002-2155-4139)

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