A mixed-methods study on the effectiveness and optimization needs of a prescription review training program: from the KAP perspective of returning trainees

Abstract

Abstract Background Prescription review training programs are widely implemented in China to meet increasingly stringent policy requirements for rational drug use. However, evidence on the effectiveness of these programs and the specific needs for their optimization, particularly from the knowledge, attitude, and practice (KAP) perspective of returning pharmacists, remains limited. This gap constrains efforts to refine training systems and support the implementation of national pharmaceutical policies. Methods An exploratory sequential mixed-methods design grounded in the KAP model was employed. Phase I involved semi-structured interviews with 15 returning trainees, with thematic analysis adopted for data coding and thematising; Phase II administered a KAP questionnaire to trainees, quantitative data were analyzed using descriptive statistics, Pearson correlation, and binary logistic regression. Results Qualitative interview revealed that trainees reported good knowledge acquisition and positive attitude transformation, but also faced practice barriers (limited pre‑review platform support, physician communication difficulties, and specialty misalignment). Quantitative survey of 394 trainees showed mean knowledge scores of 32.6±3.2, attitude scores of 28.7±2.4, and practice scores of 32.3±3.6, with significant positive correlations among them. Regression analysis identified low usefulness of role‑playing and insufficient communication training demand were independent associated factors for poor practice translation (P<0.05), while workplace contextual factors(e.g. pre‑review platform) were not significant. Both qualitative and quantitative findings consistently indicated strong trainee demand for extended training, specialty focused content, communication practice, and post-training support. Conclusion Prescription review training effectively improves pharmacists’ knowledge and professional attitude. However, despite high knowledge and practice scores, qualitative findings revealed persistent self reported difficulties in applying training to practice, indicating a discrepancy between measured outcomes and perceived challenges. The two finding are complementary rather than contradictory. Addressing this discrepancy requires integrated interventions, including strengthened communication skills training, specialty-adapted content, improved institutional support platforms, and sustainable post-training follow-up.