Primary Health Care Physicians' Attitude and Practice to Evidence-Based Medicine in Tabuk City - Research Paper Example

The Attitude and Use of Physicians towards Evidence Based Medicine in Tabuk Saudi Arabia Objectives: To make a thorough investigation of the use of evidence based medicine among Physicians in the area of Tabuk City in relation to the accessibility of authentic and highly validated material and to assess the feasibility and viability of evidence based medicine in relation to the attitude of Physicians of the Tabuk City area. Methods: Random samples of physicians in Tabuk City was procured based on various criteria such as access to EBM sources, their knowledge and attitude two words the usage, relevance in their practice, time saved and how much improvement was made in patient management. Different questionnaires were used to asses each of the above criteria. Results: The overall response rate towards the different questionnaire surveys was 86.7%. The results for moving from an opinion based practice through an EBP was 52.9%. In gauging the major barriers faced by Physicians, 65% of them were of the opinion that time was the biggest barrier. In gauging their education, it was found that 41% of them were post graduates. In evaluating the kind of training undergone by the physicians, 25.5% of them had formal training in relation to EBM, while 74.51% did not undergo any course on the usefulness of EBM. Assessing their attitude towards Evidenced-based medicine it was found that 27.5% of them voted towards the promotion of EBM as (100%), 21% as (80%) while 92.2 of the entire study group raked their attitude more than 50%. The final mean score for the attitude of physicians towards current promotion of EBM accounted for (81.57) .χ2 = 2.82, p-value = 0.03. Conclusion: It was proved that there was dire need among the Physicians in the city of Tabuk to increase their knowledge and skill related to the Evidence Based Medicine. To achieve this goal, the use of various intervention strategies should be implemented to bridge the wide gap especially for those physicians who have very limited access. Introduction Health Care Management based on EBM, accounts for better results than the traditional method of care. New evidence from Clinical research both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious and safer. (2) However, most medical texts are not always based on evidence. Traditional continuous medical education does not work in improving professional practice. (11, 12) In addition to the expansion in research and discrepancy in validity, (13) so currently there is an increased interest in narrowing the gap between research findings and their implementation in clinical practice. (14) This is where Evidence based medicine (EBM) becomes crucially important in helping to bridge the gap by integrating the most sophisticated research evidence with the best clinical expertise. This research paper is based on the crucial importance of EBM as an indelible tool in a physician’s practice for better patient outcomes related to the Tabuk City area. Methods: Several studies have reported that family physicians and general practitioners have a positive attitude toward evidence-based medicine (15-16) and a belief that it improves patient care. (15) This research study is going to make an investigation of physicians in Tabuk city and their attitude towards EBM and the extent to which they incorporate it into their daily practice based on their knowledge and skill. Tabuk city is located in the North-west area of the Kingdom of Saudi Arabia. Its area is about 95000 km2 and it covers about 5% of the area of the Kingdom Saudi Arabia. It is set about 600-800 m above sea level. It has a population of about 750000 (1420H) and is a militarism city. NWAFH is a governmental hospital serving a special governmental sector. There are many Primary Health Care Centers covering Tabuk area, in addition to Air Base Clinic and all these centers serve the military and its dependants in Tabuk area and the village around it. The Ministry of Health has two main hospitals in Tabuk city and 14 Primary Health Care centers serving all the people in Tabuk city. The study was cross-sectional in nature and involved all the physicians serving in the different Primary Health Care Centers, the Air Base Clinic and the hospitals that come under the Ministry of Health, in addition to other hospitals belonging to Tabuk city. Since all the participants were well educated grown- ups, there was no hitch in understanding what was expected of them without any pressure being involved. This physician based cross-sectional study was of great preference because it was not only feasible, but also inexpensive and more logistically viable as it was not time bound. All the physicians of the various Primary Health Care Centers were divided into 3 different study groups. Physicians were not restricted or biased in any way and were given full freedom to express their thoughts and ideas on what they felt about shifting from an Opinion – Based Medicine to Evidence Based Medicine. Prior permission for conducting the study was obtained fro the Research and Ethics Committee of the North West Armed Forces Hospital in Tabuk, in addition to other related authorities. Confidentiality of every member belonging to the different groups was assured in the form of written and verbal agreements which were signed and delivered for the sole purpose of this research study. Questionnaires that were relevant for each of the groups were distributed among the physicians who had to complete them and hand them over once again. A self administered questionnaire adopted from McColl et al (1) – was utilized for this purpose. The questionnaire recorded the demographic data such as age, gender, date of graduation from medical school, post graduate study and the date of completing the questionnaire. This study covered many outcome variables including respondents attitude towards evidence-based medicine, ability to access and interpret evidence, perceived barriers to practicing evidence-based medicine and the best method of moving from opinion-based medicine to evidence-based medicine. The collected data was analyzed by using SPSS software version 13 and once the data entry was completed, the data was analyzed by using Chi square and other appropriate statistical tests, for non-continuous variables, in addition to other appropriate tests. Results: All the participating Physicians from the different primary health centers and hospitals from the Tabuk City area were divided into three groups comprising of 95 Primary Health Care Physicians from the Northwest Armed Forces in group A, 40 Primary Health Physicians from the Ministry of Health in Group B and 32 Primary Health Care Physicians from the private Polyclinic areas in group C. Of the 38 Primary Care Centers in the study area, 15 centers were included in the study. A total of 51of the 58 physicians (86.7%) attended and filled the questionnaires. 61% of the physicians were males (fig 1). 45% of the physicians were in the age group of (40- 49) followed by those who were in the age group (30 – 39) (fig 2). The year of graduation was 1990. Regarding their postgraduate education 41% of the physicians were postgraduates. Of the 51 physicians who had responded which was 27.5% had ranked their attitude towards current promotion of EBM as (100%) followed by 21% of the others who ranked their attitude as ( 80%) the grand total of those who ranked their attitude more than 50% accounted for about 47 physicians representing 92.2% of the study group (table 1). The mean score for the attitude of physicians towards current promotion of EBM accounted for (81.57) .χ2 = 2.82, p-value = 0.03. In rating the answers of the physicians regarding the attitude of most of their GP colleagues towards EBM, 41.2% of physicians rated it as ( Read More