Developing a behaviour change intervention using information about greenhouse gas emissions to reduce liquid antibiotic prescribing.

Introduction: The determinants of antimicrobial prescribing often involve social influence, which can be harnessed through behaviour change techniques (BCTs). While previous studies have used BCTs to address antimicrobial resistance, there is a lack of evidence regarding their application to address climate change-related issues in antibiotic prescribing. This study aimed to develop a behaviour change intervention (BCI) using information about greenhouse gas emissions to reduce liquid antibiotic prescribing.

Methods: A convenience sample of participants from a primary care practice in North East England participated in semi-structured interviews. The intervention design was guided by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation - Behaviour (COM-B) model. Data were analysed thematically, mapped to the TDF, and used to refine the BCI.

Findings: Participants identified motivating factors related to high rates of liquid prescribing, climate change, and solid oral dosage form (pill) aversion. The broader context of practice, such as initiatives reduce cost and improve sustainability, provided opportunities for intervention. Participants demonstrated the capability to change prescribing behaviours and expressed willingness to share resources within their teams.

Conclusion: This study underscores the potential of BCIs using greenhouse gas emissions data to reduce liquid antibiotic prescribing. Further research should focus on implementing and evaluating these interventions in practice settings.