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GPs want tailored, user friendly evidence summaries--a cross sectional study in New South Wales
Lyndal J Trevena1, Les Irwig, Anna Isaacs
1School of Public Health, The University of Sydney, New South Wales. lyndalt@health.usyd.edu.au
Background:
This study aimed to measure the use of, and barriers to, using evidence among general practitioners since computerisation of general practice; GP preference for patient involvement in health care decisions; and GPs' preferred strategies to increase the use of evidence.
Methods:
A cross sectional, open ended telephone survey was conducted with 107 (out of 155) New South Wales GPs randomly selected from the New South Wales Medical Board register. The survey sought self report to open ended questions about information sources informing decisions, perceived barriers to using evidence, and suggested strategies to improve clinical decisions, plus Degner scale for patient involvement.
Results:
Evidence based sources remained the least likely to be used for informing decisions about patient care (23.4%). Opinion based sources were most commonly used (50.5%), with industry sponsored sources second (27.1%). Rural GPs were more likely to use opinion based sources (OR=1.55, 95% CI: 1.00-2.40). The most common perceived barriers were 'a lack of time' (22.0%), 'a lack of evidence or conflicting evidence' (13.1%), 'not knowing where to look' (10.3%) and 'not being able to tailor evidence to individual patients' (9.3%). The majority of GPs (72.0%) preferred patients to have some role in decision making. The most common suggestions for improving decision making were 'simply formatted evidence summaries' (28.0%) and 'mechanisms for tailoring evidence with individual patients' (13.1%).
Discussion:
The use of evidence based sources for clinical decision making in general practice remains limited. Potential strategies to overcome this should focus on providing more user friendly evidence summaries, involving patients in evidence based decision making, and finding mechanisms to tailor evidence to individual patients.
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