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Article
Rural doctors’ views on and experiences with evidence-based medicine: The FrEEDoM qualitative study
PloS One
  • Ranita Hisham, University of Malaya, Kuala Lumpur
  • Su M Liew, University of Malaya, Kuala Lumpur
  • Chirk J Ng, University of Malaya, Kuala Lumpur
  • Kamaliah M Nor, Family Health Development Division, Ministry of Health, Putrajaya, Malaysia
  • Iskandar F Osman, Klinik Kesihatan Jaya Gading
  • Gah Juan Ho, University of Malaya, Kuala Lumpur
  • Nurazira Hamzah, University of Malaya, Kuala Lumpur
  • P. Glasziou, Bond University
Date of this Version
3-31-2016
Document Type
Journal Article
Grant Number
University of Malaya Research Grant (UMRG 474/12HTM)
Publication Details

Published version

Hisham, R., Liew, S.M., Ng, C.J., Nor, K.M., Osman, I.F., Ho, G.J., Hamzah, N., Glasziou, P. (2016). Rural doctors’ views on and experiences with evidence-based medicine: The FrEEDoM qualitative study. PloS One, 11(3), e0152649.

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© Copyright, 2016 Hisham et al.

Distribution License
Creative Commons Attribution 4.0
Abstract

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.

Citation Information
Ranita Hisham, Su M Liew, Chirk J Ng, Kamaliah M Nor, et al.. "Rural doctors’ views on and experiences with evidence-based medicine: The FrEEDoM qualitative study" PloS One Vol. 11 Iss. 3 (2016) p. 1 - 15 ISSN: 1932-6203
Available at: http://works.bepress.com/paul_glasziou/189/