Sources of information and attitudes towards evidence-based healthcare: a survey of Swiss physicians

Article type
Authors
Burnand B1, Bengough T2, Barry A3, Pidoux V3, Amiguet M3, Bovet E4
1Cochrane Switzerland and Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
2Austrian Federal Institute of Health Care, Austria
3Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
4Haute Ecole de Santé Vaud and Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
Abstract
Background: Barriers to knowledge translation generate delays to adopt new effective interventions, persistence of obsolete treatments, overuse of ineffective interventions and underuse of effective care.
Objectives: To examine current knowledge translation practices of Swiss physicians.
Methods: We surveyed French- and German-speaking private practice physicians. Semi-structured open-ended interviews and focus groups targeting family physicians, psychiatrists, cardiologists, endocrinologists, and orthopaedic surgeons in Switzerland, and the existing literature, allowed us to draft an interview questionnaire for the computer-assisted web interview (CAWI) of a large sample of these groups of physicians (summer 2014). We targeted sources of and barriers to information, and adherence to evidence-based medicine (EBM) principles. We computed a score of adherence to EBM based on five items and used uni- and multivariate analyses.
Results: Twenty-nine physicians (21 men) participated in the qualitative study and 985 in CAWI (15% participation, similar among the three Swiss language regions and physicians’ specialty). CAWI indicated that the main sources of information of family physicians included congresses (41%), practice guidelines (38%), colleagues (37%) and specialists (33%), systematic reviews (28%), knowledge syntheses (24%) and quality circles (21%). Perceived usefulness of EBM in daily practice was considered very high by 20%, high by 56%, low by 20% and very low by 4% of physicians. Adherence to EBM decreased slowly with age (-2.1 percentage-points/10 years), and was lower in endocrinologists, family physicians, orthopaedic surgeons and psychiatrists ( -7.0, -8.4, -12.8, -13.8 percentage-points, respectively) compared to cardiologists.
Conclusion: We observed that physicians working in Switzerland use various sources of information to update their knowledge, but that no single source dominates. Evidence-based sources are often used and three-quarters of physicians adhere to its principles. The optimal source, type and format of information for busy physicians are uncertain.