Evaluating the effect of computer-based education on pharmacist behaviour regarding point-of-care testing

Abstract

Background

Recent regulatory changes in Ontario have enabled pharmacists to perform point-of-care testing (POCT) to manage chronic diseases. With the introduction of any new service(s), educational interventions can aid acceptance and implementation. Computer-based education (CBE) improves pharmacists' knowledge, but there is little evidence of its effect on pharmacist behaviour. This study assessed the impact of CBE on pharmacist knowledge, behaviour intention, and adoption of POCT.

Methods

A three-month, web-based, randomized controlled trial was conducted between April 2024 and Sep 2024 with community pharmacists in Ontario, Canada. The intervention group was asked to complete two POCT modules using a CBE platform, while the control group was asked to review reference materials about POCTs. The primary outcome, the difference in the number of POCTs performed, was collected using monthly reports. Secondary outcomes (knowledge gain and changes in the Theory of Planned Behaviour (TPB) constructs: attitude, subjective norm, perceived behavioural control, and behaviour intention) were assessed using selfreported surveys. Generalized linear models (GLM) with negative binomial distribution were used to analyze the number of POCTs. Knowledge gain was analyzed using repeated measure ANOVA and binomial regression. TPB constructs were analyzed within groups using paired sample t-tests and between groups using two-sample ttests.

Results

Of the 261 pharmacists recruited, 201 completed the pre-study survey, 135 completed the one-week post-test, and 104 completed the three-month post-test. There was a significant difference in knowledge test scores between the two groups at one week (P = .001) and three months (P < .00). There was no significant difference in behavioural constructs between the two groups at three months. However, attitude increased significantly for both groups (intervention group 3.6 ± 0.6 Vs. 3.95 ± 0.5 P < .001; control group 3.5 ± 0.6 Vs. 3.8 ± 0.5 P < .001). There was no significant change in the number of POCTs performed after one, two, and three months for both study groups.

Conclusion

CBE improved pharmacists' knowledge of POCT but showed a limited effect on pharmacist intention or behaviour. The study highlighted that knowledge alone does not influence behaviour change. Factors such as organizational support, adequate reimbursement, and expanded practice scope (e.g., prescribing) are critical to enhance POCT implementation.