A qualitative exploration of digital medicines information usage: Insights from an evaluation of the BNF

Objectives:: To explore the driving and resisting forces to the use of digital medicines information in the context of the British National Formulary (BNF) and British National Formulary for Children (BNFc). Methods:: Qualitative semi-structured interviews were carried out with 25 doctors, pharmacists and nurses. Data were analysed via thematic analysis. Results:: Key drivers identified included organisations making digital use of BNF/BNFc easier through measures such as electronic prescribing systems, compatible handheld devices and training/induction sessions for staff. The COVID-19 pandemic had expedited the shift to digital BNF/BNFc usage in some settings. A strong driver of digital usage was the desire by staff to use the most up-to-date information. Reduced access to print copies was a common initial driver of digital usage, whilst ease of searching and speed of access often acted to consolidate digital usage. Important resisting forces included lack of supporting organisational digital infrastructure and an onus on individuals to obtain access to digital platforms, particularly through personal smartphones. Poor prior experience of earlier digital BNF/BNFc platforms had also prevented participants from using them again. Conclusions:: More driving than resisting forces were identified and, in most settings, a transition to digital BNF/BNFc usage is underway, which has been expedited by the COVID-19 pandemic. However, this is not happening uniformly across the NHS and there continue to be strong resisting forces to digital BNF/BNFc usage, particularly at organisational level. Public interest summary:: The British National Formulary (BNF) and British National Formulary for Children (BNFc) provide information about all medicines prescribed in the UK. They are available as a book, a website and an app. As healthcare information becomes increasingly digital, it is important to understand how this is used by healthcare staff and we spoke to doctors, nurses and pharmacists about how they use the BNF/BNFc. We found that staff are increasingly using the digital BNF/BNFc and that the COVID-19 pandemic has speeded up this transition. Staff are likely to use the digital BNF/BNFc where their organisation makes it easy to do so, such as through access to IT equipment and electronic prescribing systems. However, many NHS organisations lack the facilities for widespread digital usage and staff are not routinely trained in using digital resources. Future efforts should focus on the digital technology itself, and on upskilling healthcare staff to use it.