Table 3 The themes, and corresponding facilitators, barriers, and domains within the Theoretical Domains Framework (TDF; version 2)
Themes | Potential facilitators to the use of aspirin for preventive therapy | Potential barriers to the use of aspirin for preventive therapy | Main TDF domain(s) |
|---|---|---|---|
Considering potential harms and benefits | Confidence in the evidence supporting aspirin for colorectal cancer prevention National guidance (i.e. NICE) recommending aspirin for preventive therapy Low concerns about using aspirin as it is a pharmacy drug | Concerns about using daily aspirin at higher doses (300-600 mg) Lack of strong evidence to support an appropriate dose of aspirin which balances the benefits and harms | Beliefs about consequences |
Healthcare pathway | Agreement among GPs and specialists on the appropriate healthcare pathway for patients to acquire a prescription for aspirin | Most GPs are unfamiliar with evidence supporting the use of aspirin for colorectal cancer prevention Lack of clarity on the appropriate treatment pathway for aspirin among people with LS Specialist clinicians in genetics may be an underutilised resource among GPs Some people with LS may be reluctant to approach their GP to discuss aspirin | Social/professional role and identity Environmental context and resources Knowledge |
Patients’ level of interest in aspirin | Patients having a high level of knowledge on the risks and benefits of aspirin Patients’ expressed preference to use aspirin | Patients who are uncertain whether to use aspirin and require further support | Knowledge Environmental context and resources |