Knowledge, attitude and practices of evidence-based medicine among doctors in selected hospitals in Sri Lanka

Article type
Authors
Abeysena C, Jayawardana P, Wickremasinghe R, Wickramasinghe U
Abstract
Background: Since the establishment of the coordinating site of the South Asian Cochrane Network in 2005, it has been conducting a series of workshops/seminars. Currently, evidence-based medicine (EBM) is included in the undergraduate as well as some postgraduate medical curricula. Objectives: To assess knowledge, attitudes and practices of EBM among doctors in selected hospitals. Methods: A descriptive study was conducted in four selected hospitals in January 2008. Study population consisted of 315 doctors. A pre-tested self-administered questionnaire was used to gather relevant information. Results: Of the 315 doctors, 271 (87%) had heard of the term EBM. Of them, 128 (47%) had heard it during undergraduate education. The sources were: lectures (n = 130; 48%), journals/books (n = 67; 24.7%) and colleagues (n = 46; 17%). Thirty per cent (n = 94) were aware of The Cochrane Library. Forty seven per cent (n = 148) claimed to understand the term systematic review and 36.5% (n = 115) the term meta-analysis. Only 24.4% (n = 77) were exposed to any form of training on EBM. All three components of EBM were known by 17.8% (n = 56), two by 24% (n = 76) and one by 39.7% (n = 125) participants. Attitudes towards EBM were good in 75.8% (n = 239), and 79.5%( n = 251) considered practice of EBM would lead to improved patient care, while 77% (n = 243) considered it as fundamental to professional practice. EBM was used in clinical practice by 53.6% (n = 169). Only 64.7% (n = 204) had access to sources of EBM, and of them. 78% (n = 157) had read articles on EBM. Only 36.2% (n = 114) referred to EBM sources when relevant. The main barriers to practicing EBM were insufficient resources (n = 245; 77.7%), overwork (n = 210; 66.6%), lack of exposure to EBM (n = 205; 65%), and lack of time (n = 204; 64.7%) and endorsement (n = 186; 59%). Conclusions: Eighty-seven per cent were aware of the phrase ‘evidence-based medicine’ and 76% had favourable attitudes towards EBM. The main barriers to practicing EBM were insufficient resources and inadequate exposure to EBM.