Table 3. TDF domains, facilitator and barrier sub-themes, and overarching themes for patients reducing opioids in the context of a PROMPPT review
TDF domainSub-themeFaBbOverarching theme
KnowledgeKnowing about and managing pain✓✓Learning to live with pain
Behavioural regulationSelf-regulating pain management✓✓
Environmental context and resourcesAccessible evidence-based resources✓
Social influencesSocial support✓✓
Social or professional role and identityChanging identities✓✓
GoalsLive better with pain✓
KnowledgeKnowing about reducing opioids✓✓Opioid reduction expectations
Behavioural regulationMonitoring for quick effectiveness of opioid reduction✓✓
Beliefs about capabilitiesUnable to cope with an opioid reduction✓
Beliefs about consequencesConsequences of reducing opioids✓✓
IntentionsIntention to reduce✓✓
EmotionsAnxious about reducing opioids✓
ReinforcementAvoid withdrawal✓
Reduce if potential benefits perceived✓
Social influencesPrescribed by healthcare professional✓Assuming a medical model
ReinforcementOpioids are necessary✓
Left on repeat prescription✓
KnowledgePharmacist knowing about and managing pain within primary care✓Pharmacist-delivered reviews
SkillsPatient-centred shared decision making✓
Social influencesPatient–clinician relationship✓✓Pharmacist–patient relationship
Supportive point of contact for pain management✓
KnowledgePatient knowledge of PROMPPT review✓Patient engagement
Environmental context and resourcesAccessibility of a PROMPPT review✓✓
Beliefs about capabilitiesAble to discuss experiences of pain, medicines, and management✓
Beliefs about consequencesWide-ranging benefits✓
PROMPPT review concerns✓
Provide a pharmacological solution✓
IntentionsIntention to engage in a PROMPPT review✓✓
GoalsFind a pharmacological solution✓
Increase understanding of pain and medicines✓
OptimismOptimistic a PROMPPT review will be helpful✓
Uncertain of personal relevancy of a PROMPPT review✓

  • aF = facilitator. bB = barrier.