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Barriers to GPs' use of evidence-based medicine: a systematic review

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Zwolsman, Sandra, te Pas, Ellen, Hooft, Lotty, Waard, Margreet Wieringa-de, van Dijk, Nynke·2012·British Journal of General Practice

DOI 10.3399/bjgp12x652382PMC PMC3381277

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Abstract

BACKGROUND: GPs report various barriers to the use and practice of evidence-based medicine (EBM). A review of research on these barriers may help solve problems regarding the uptake of evidence in clinical outpatient practice. AIM: To determine the barriers encountered by GPs in the practice of EBM and to come up with solutions to the barriers identified. DESIGN: A systematic review of the literature. METHOD: The following databases were searched: MEDLINE (PubMed), Embase, CINAHL, ERIC, and the Cochrane Library, until February 2011. Primary studies (all methods, all languages) that explore the barriers that GPs encounter in the practice of EBM were included. RESULTS: A total of 14 700 articles were identified, of which 22 fulfilled all inclusion criteria. Of the latter, nine concerned qualitative, 12 concerned quantitative, and one concerned both qualitative and quantitative research methods. The barriers described in the articles cover the categories: evidence (including the accompanying EBM steps), the GP's preferences (experience, expertise, education), and the patient's preferences. The particular GP setting also has important barriers to the use of EBM. Barriers found in this review, among others, include lack of time, EBM skills, and available evidence; patient-related factors; and the attitude of the GP. CONCLUSION: Various barriers are encountered when using EBM in GP practice. Interventions that help GPs to overcome these barriers are needed, both within EBM education and in clinical practice.

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Authors: Zwolsman, S., te Pas, E., Hooft, L., Waard, M. W.-D., & van Dijk, N.
Affiliations: Amsterdam UMC Location University of Amsterdam (NL)
ORCID: Zwolsman, Sandra
Hooft, Lotty
van Dijk, Nynke
Venue: British Journal of General Practice
Publisher: Royal College of General Practitioners
Published: 2012-07
Volume: 62
Issue: 600
Pages: e511-e521
ISSN: 0960-1643 (ISSN-L)
1478-5242
DOI: 10.3399/bjgp12x652382
PMC: PMC3381277
OpenAlex: W2102169654
Cited by: 208
References: 79
Citations by year: 2026: 11 · 2025: 7 · 2024: 9 · 2023: 7 · 2022: 23 · 2021: 17 · 2020: 22 · 2019: 21 · 2018: 14 · 2017: 17 · 2016: 13 · 2015: 18 · 2014: 17 · 2013: 11 · 2012: 1
FWCI: 2.29
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: British Journal of General Practice (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Funders: Universiteit van Amsterdam
Topics: Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords: evidence-based medicine, barriers to evidence use, general practitioners, primary care, patient preferences, time constraints, outpatient practice
MeSH terms: Attitude of Health Personnel, Clinical Competence, Decision Making, Humans, Patient Participation, Practice Patterns, Physicians', Quality Assurance, Health Care, Evidence-Based Medicine, Patient Preference, General Practice

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Barriers to GPs' use of evidence-based medicine: a systematic review

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