Barriers to Evidence-Based Practice in Health System: A Systematic Review

Q3 Medicine

Evidence Based Care Journal Pub Date : 2021-11-13 DOI:10.22038/EBCJ.2021.60075.2561

Deniz Naghibi, S. Mohammadzadeh, S. Azami-aghdash

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引用次数: 6

Abstract

Background: Evidence-Based Practice (EBP) means combining the best available evidence with clinical experiences, patients’ values and expectations. The findings of our previous systematic review, published in 2014, indicated that EBP faces numerous barriers.Aim: This study aims to update prior study findings by reviewing studies published after 2014.Method: The data was gathered by searching relevant keywords in PubMed, Cochrane, Scopus, and Google Scholar between 2014 and 2021. The articles were screened based on their titles, abstracts and full texts, respectively, considering the inclusion criteria. The data was extracted using a data extraction form consisting of author, year, country, type of study, area of study, list of barriers, and their number in each study. Finally, the data was analyzed, summarized, and reported using content-analysis by descriptive statistics such as percentage and frequencyResults: Finally, 77 articles were included in the study. Only 13% of the studies were conducted in low and middle-income countries. Extracted barriers were categorized into five areas of specialized / hospital care (50 studies and 67% of the barriers), primary health care (5 studies and 6% of the barriers), rehabilitation care (11 studies and 11% of the barriers), medical education (5 studies and 5% of the barriers), and healthcare management and decision making (6 studies and 12% of the barriers). Based on the content-analysis results, barriers were divided into six main themes: system-level barriers, barriers related to the evidence, individual-related barriers, communicational barriers, barriers related to the resources, patient-related barriers, external barriers. Lack of time, support, and skills had the highest repetition, respectively.Implications for Practice: The results of our previous study were updated, and further barriers were identified and reported. Policymakers and managers can use the results as a practical guide to expand and improve EBP and remove barriers

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卫生系统循证实践的障碍:系统回顾

背景:循证实践(EBP)是指将现有最佳证据与临床经验、患者价值观和期望相结合。我们之前发表于2014年的系统综述的研究结果表明，EBP面临许多障碍。目的:本研究旨在通过回顾2014年以后发表的研究来更新先前的研究结果。方法:通过检索2014 - 2021年PubMed、Cochrane、Scopus、Google Scholar等相关关键词收集数据。根据纳入标准，对文章的标题、摘要和全文分别进行筛选。使用数据提取表提取数据，数据提取表包括作者、年份、国家、研究类型、研究领域、障碍列表及其在每项研究中的数量。最后，通过描述性统计(如百分比和频率)对数据进行分析、总结和报告。结果:最终，77篇文章被纳入研究。只有13%的研究在低收入和中等收入国家进行。提取的障碍被分类为五个领域:专科/医院护理(50项研究和67%的障碍)、初级卫生保健(5项研究和6%的障碍)、康复护理(11项研究和11%的障碍)、医学教育(5项研究和5%的障碍)、医疗保健管理和决策(6项研究和12%的障碍)。根据内容分析结果，将障碍分为六大主题:制度层面障碍、证据相关障碍、个体相关障碍、沟通障碍、资源相关障碍、患者相关障碍、外部障碍。缺乏时间、支持和技能分别具有最高的重复率。对实践的启示:我们更新了先前研究的结果，并确定和报告了进一步的障碍。决策者和管理者可以将结果作为扩展和改进EBP并消除障碍的实用指南

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Evidence Based Care Journal Medicine-Health Policy

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： The Evidence Based Care Journal (EBCJ) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of patient care. The primary aim is to promote a high standard of clinically related scholarship which advances and supports patient care in practice. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, EBCJ seeks to enrich insight into clinical needs and the implications for patient care intervention and models of service delivery. Emphasis is placed on clinical practicality of research findings and strength of study design. EBCJ is essential reading for anyone involved in healthcare professions, whether clinicians, researchers, educators, managers, policy makers, or students. Contributions are welcomed from other health professionals on issues that have a direct impact on patient care.