FAMILY PHYSICIANS' KNOWLEDGE AND APPLICATION OF EVIDENCE BASED MEDICINE IN AL-WAZARAT HEALTH CARE CENTER, PRINCE SULTAN MILITARY MEDICAL CITY, RIYADH 2016

Background: Evidence-based medicine (EBM) has emerged as an international priority in efforts to reduce unwarranted variations in medical practice and to improve patient safety and health care quality. There is lack of recent data examining the awareness and use of EBM among family physicians in Saudi Arabia, specially after the recent incorporation of EBM in the curricula of medical schools and improvement of internet access. Additionally, awareness and use of EBM databases specially the Cochrane library have never been the focus of previous studies. Moreover, there is lack of data on physician and system factors associated with better use of EBM. Objective: To assess the level of awareness and use of EBM databases including Cochrane Library among family physicians and to determine demographic and occupational characteristics associated with better use of EBM databases. Methods: A cross-sectional design was used to examine family physicians working in Al-Wazarat health care center in Riyadh between October 2016 and July 2017. Data were collected using a self-administered questionnaire which was slightly modified from the questionnaire validated and used before. Results: The current analysis included 46 family physicians. The average age was 40.4 +/- 4.1 years and 76.1% of the physicians were males. The majority (93.5%) of the study physicians reported using the internet to solve dilemmas about their patients. The majority (89.1%) were able to recognize systematic review of randomized controlled trials as the top level of evidence. Approximately 65.9% of the study physicians thought that the Cochrane Library could help them in solving the problems encountered in their practice. Approximately 56.8% of the study physicians had internet access at work and 45.7% had access to EBM databases. Approximately 47.8% were using specialized EBM databases and 34.8% were using the Cochrane Library and/or reading its systematic reviews. Having access to EBM databases was the only factor that was significantly associated with frequent use of specialized EBM databases while having internet access at work, having access to EBM databases, hearing about the Cochrane Library, and to less extent positive attitude towards the Cochrane Library were associated with frequent use of the Cochrane Library and/or reading its systematic reviews. Conclusions: The levels of awareness and use of EBM observed in the current study are considered better than reported before in Saudi Arabia but still suboptimal in some aspects. There still need for more educational activities to improve EBM skills and use. Further interventional studies are needed to examine the impact of fixing the insufficient knowledge and limited access to EBM information on the quality of patient care