Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27031700
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Rural Doctors Views on and Experiences with Evidence-Based Medicine: The FrEEDoM
Qualitative Study
#MMPMID27031700
Hisham R
; Liew SM
; Ng CJ
; Mohd Nor K
; Osman IF
; Ho GJ
; Hamzah N
; Glasziou P
PLoS One
2016[]; 11
(3
): e0152649
PMID27031700
show ga
BACKGROUND: Evidence-based medicine is the integration of individual clinical
expertise, best external evidence and patient values which was introduced more
than two decades ago. Yet, primary care physicians in Malaysia face unique
barriers in accessing scientific literature and applying it to their clinical
practice. AIM: This study aimed to explore the views and experiences of rural
doctors' about evidence-based medicine in their daily clinical practice in a
rural primary care setting. METHODS: Qualitative methodology was used. The
interviews were conducted in June 2013 in two rural health clinics in Malaysia.
The participants were recruited using purposive sampling. Four focus group
discussions with 15 medical officers and three individual in-depth interviews
with family medicine specialists were carried out. All interviews were conducted
using a topic guide and were audio-recorded, transcribed verbatim, checked and
analyzed using a thematic approach. RESULTS: Key themes identified were: (1)
doctors viewed evidence-based medicine mainly as statistics, research and
guidelines, (2) reactions to evidence-based medicine were largely negative, (3)
doctors relied on specialists, peers, guidelines and non-evidence based internet
sources for information, (4) information sources were accessed using novel
methods such as mobile applications and (5) there are several barriers to
evidence-based practice, including doctor-, evidence-based medicine-, patient-
and system-related factors. These included inadequacies in knowledge, attitude,
management support, time and access to evidence-based information sources.
Participants recommended the use of online services to support evidence-based
practice in the rural settings. CONCLUSION: The level of evidence-based practice
is low in the rural setting due to poor awareness, knowledge, attitude and
resources. Doctors use non-evidence based sources and access them through new
methods such as messaging applications. Further research is recommended to
develop and evaluate interventions to overcome the identified barriers.
free
free
free
