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Background
During ancient era EBM consists of ancient historical accounts of what may be loosely termed as EBM which was followed by the development of new growth era of EBM around seventeenth century. During this period personal journals and textbooks were kept and become more prominent. Around 1900-1970s there was an emergence of transitional era where knowledge could be shared more easily in textbooks and eventually peer-reviewed journals. And after that period evidence based medicine advanced into modern era of EBM where by technology a large role had in the advancement of EBM (Offringa et al, 2003). Computers and database software have now the capacity to com., pile large amounts of data, and the availability of internet has also allow incredible access to masses of data and information. Then in the 1996, the term was more formally defined (Sacket et al, 1996) who stated that EBM was "the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients" However the term evidence based medicine is relatively new. Regardless of all those transition of EBM still there is little knowledge and application of EBM is still minimal among health workers worldwide especially in sub Saharan Africa this might be due to scarcity in resources. As history, clearly shown us, evidence and data do not immediately translate into evidence based practice (Abate, 2014)
Objective: The main objective of this study was to assess the attitude, awareness and practice of evidence based medicine among health workers in KCMC
Methodology: A descriptive cross sectional study design was conducted from May to June 2016 and included 422 sampled from registered doctors and nurses working at Kilimanjaro Christian Medical Centre. Data was collected using a questionnaire which was administered to the selected doctors and nurses. All information filled were anonymous; there was no personal identification of the participants to insure confidentiality and reliability of data filled. Data collected were checked for completeness and accuracy .The data were coded, entered, processed and analyzed using statistical package for social science (SPSS) for windows version 20. Descriptive analysis was used where by frequencies and percentages of all outcome variables vs exposure variables were computed and results were presented using charts and tables.
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Results
A total of 422 health workers were given the questionnaires. Out of which 300 only responded and returned their full filled questionnaire, which makes a response rate of 71%. Nonresponse was due to lack of time to fill the questionnaire and some did not want to participate in the study.
With regard to attitudes towards EBM respondents were assessed by their preferences to information sources during clinical decision making and opinion towards EBM. Majority of the respondents 193(64.8%) strongly agreed to have a positive attitude towards EBM especially when it comes to knowledge update, important to apply at KCMC majority of the respondents 175(58.3%) strongly agreed to have a positive attitude. Lack of knowledge on EBM has impact on medical care, majority of the respondents 129(43%) strongly agreed to have a positive attitude on this. Some have negative attitude in case of EBM is difficult to apply in daily practice and majority of the respondents 114(38%) disagreed to that. But also some respondents responded I don’t know
Majority of the health workers at KCMC are aware of evidence based medicine, so with regard to awareness of health workers at KCMC, those who have heard about EBM were 264(88%) of all the respondents and incase of those who have ever used EBM were 203(67.7%) of all the respondents. At KCMC 174(58%) of all respondents aren’t aware if they had exposure to EBM during their medical school.
This study identifies three most common barriers to EBM application were as follows: lack of time to access EBM sources 148(49.3%), insufficiency of basic EBM skills 133(44.3%) followed by EBM as a new concept 96(33%).
Conclusion
EBM practice in assessing treatment options for individual patients is the gold standard tool in which all health workers should adopt and put it into practice for the well-being of the patients. So improved access to resources online (articles, journals and updated books etc.) enabled clinicians to incorporate EBM in daily clinical practice and are now more than ever in a position to implement evidence at the point of contact with individual patients, ensuring that evidence is translated into practice.
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Evidence-based medicine is not an effort to replace clinical judgment and experience of the health workers but instead helps the clinician to incorporate the scientific evidence into practice to improve the well-being of patients. In general, attitude towards EBM is positive and the awareness among health workers is growing too. However, barriers in its application were noticeable like lack of time, insufficiency EBM basic skills and EBM as a new concept. |
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