Article type
Year
Abstract
Background: Principles and practice of Evidence Based Medicine (EBM) are widely promoted and increasingly accepted in many industrialised countries. However, these principles have not yet been promoted extensively in developing countries and the reasons for lack of awareness and barriers to practice of EBM might also be different in these countries.
Objectives: The main aim of this study was to assess the knowledge, attitude and practice of Evidence Based Medicine amongst health professionals in Zimbabwe.
Methods: This was a cross-sectional study involving general practitioners (GP) and pharmacist working in the private health sector of Zimbabwe. A self-administered questionnaire was sent by mail to 184 general practitioners registered with the College of Primary Care Physicians of Zimbabwe and to 123 pharmacies registered with the Medicines Control Authority of Zimbabwe. The samples represented 50% of the above registers. The questionnaire was divided into four sections and used 12 close-ended and 1 open-ended question to assess current opinion, knowledge and practice of EBM. Section four was used for collection of demographic details. As an incentive, those who replied within 2 months were entered into a draw for a book voucher in the value of US $25.
Results: The overall response rate was 25%. The majority (57%) of the respondents, were between the age of 30 to 45 years and were male (72%). Most of the respondents expressed positive attitudes towards the practice of EBM. They thought external evidence is most useful in deciding therapy (97%) and estimating risk (72%) while fewer of them perceived it to be useful for diagnosis (59%) and prognosis (55%). The majority (81%) of them declared that they practice EBM by a) selecting and applying the evidence themselves, b) using evidence based summaries c) following evidence-based guidelines. However the majority of them were neither aware nor had used some of the selected EBM resources (e.g. Cochrane Library, ACP Journal Club, etc.). Approximately half of them were not familiar with EBM terms like meta-analysis, randomisation, odds ratio, number needed to treat and only about 10% of them thought that they understood and could explain these terms to others. They needed information for individual patient care 4 to 5 times a week. On rating information sources to be used for clinical decision making, textbooks were rated as the most important source, followed by colleagues and medical journals graded as least important. 65% of GPs and 20% of pharmacists had access to Medline. Those who used Medline accessed it on average 4 times a week. However 56% of GPs and 80% of pharmacists have never used Medline. They perceived the most important barriers to EBM as availability and access to recent evidence, lack of time, poor dissemination of clinically important information, ignorance of it's existence (i.e. lack of promotion, lack of critical appraisal skills) and limited financial resources.
Conclusion : While positive attitudes have been expressed towards EBM, low awareness of principles and practical knowledge of EBM were detected in this study. A discrepancy between perceived evidence-based practice and actual practice was also found. Wider promotion and training can help health professionals to become familiar with evidence-based practices while better utilisation of information technology and dissemination of clinically important evidence can remove some of the barriers to accessing this information.
Objectives: The main aim of this study was to assess the knowledge, attitude and practice of Evidence Based Medicine amongst health professionals in Zimbabwe.
Methods: This was a cross-sectional study involving general practitioners (GP) and pharmacist working in the private health sector of Zimbabwe. A self-administered questionnaire was sent by mail to 184 general practitioners registered with the College of Primary Care Physicians of Zimbabwe and to 123 pharmacies registered with the Medicines Control Authority of Zimbabwe. The samples represented 50% of the above registers. The questionnaire was divided into four sections and used 12 close-ended and 1 open-ended question to assess current opinion, knowledge and practice of EBM. Section four was used for collection of demographic details. As an incentive, those who replied within 2 months were entered into a draw for a book voucher in the value of US $25.
Results: The overall response rate was 25%. The majority (57%) of the respondents, were between the age of 30 to 45 years and were male (72%). Most of the respondents expressed positive attitudes towards the practice of EBM. They thought external evidence is most useful in deciding therapy (97%) and estimating risk (72%) while fewer of them perceived it to be useful for diagnosis (59%) and prognosis (55%). The majority (81%) of them declared that they practice EBM by a) selecting and applying the evidence themselves, b) using evidence based summaries c) following evidence-based guidelines. However the majority of them were neither aware nor had used some of the selected EBM resources (e.g. Cochrane Library, ACP Journal Club, etc.). Approximately half of them were not familiar with EBM terms like meta-analysis, randomisation, odds ratio, number needed to treat and only about 10% of them thought that they understood and could explain these terms to others. They needed information for individual patient care 4 to 5 times a week. On rating information sources to be used for clinical decision making, textbooks were rated as the most important source, followed by colleagues and medical journals graded as least important. 65% of GPs and 20% of pharmacists had access to Medline. Those who used Medline accessed it on average 4 times a week. However 56% of GPs and 80% of pharmacists have never used Medline. They perceived the most important barriers to EBM as availability and access to recent evidence, lack of time, poor dissemination of clinically important information, ignorance of it's existence (i.e. lack of promotion, lack of critical appraisal skills) and limited financial resources.
Conclusion : While positive attitudes have been expressed towards EBM, low awareness of principles and practical knowledge of EBM were detected in this study. A discrepancy between perceived evidence-based practice and actual practice was also found. Wider promotion and training can help health professionals to become familiar with evidence-based practices while better utilisation of information technology and dissemination of clinically important evidence can remove some of the barriers to accessing this information.