Using the theory of planned behavior to examine pharmacists' intention to utilize a prescription drug monitoring program database

Background: Prescription drug monitoring programs (PDMPs) are state-operated electronic databases that contain patients' controlled drug histories. Most states provide these data to pharmacists via online web portals to combat prescription drug abuse and diversion. Objectives: The objectives of this study were to: 1) explore the theory of planned behavior's (TPB) utility in predicting Texas pharmacists' intention to utilize an online accessible PDMP; 2) to determine the contribution of each construct, attitude (A), subjective norm (SN) and perceived behavioral control (PBC) in predicting pharmacists' intention; and 3) test whether the addition of perceived obligation (PO) is significantly related to pharmacists' intention. Methods: A cross-sectional, 36-item questionnaire was developed from focus groups and literature of pharmacists' views regarding prescription drug abuse. A total of 998 practicing Texas community pharmacists were surveyed to collect data on their intention to utilize a PDMP database. Descriptive statistics, multivariate and hierarchical logistic regression analyses were used to address the study objectives. Results: The response rate was 26.2% (261/998). TPB constructs were significant predictors of pharmacists' high intention to utilize the PDMP. 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). SN was the strongest predictor of pharmacists' high intention (OR=2.2, 95% CI=1.4-3.3). Pharmacists with high PBC were also twice as likely to have high intention (OR=1.9, 95% CI=1.2-3.0). Additionally, pharmacists' PO contributed to the prediction of high intention (OR=1.8, 95% CI=1.0-3.1) above that explained by the TPB model constructs (X²=4.14, P<0.05). Conclusions: TPB with the addition of PO was useful in predicting pharmacists' high intention to utilize a PDMP database. Interventions that address pharmacists' A, SN, PBC, and PO may be valuable to increase pharmacists' high intention. Pharmacists' utilization of PDMPs may lead to a decrease in themorbidity and mortality associated with prescription drug abuse. Future studies that assess whetherintention to use PDMPs translates to actual usage are needed to strengthen these findings.