Barriers to implementation of evidence-based practice in physiotherapy

Abstract

Background: Patient and clinician relationship plays a pivotal role in the progress of treatment. Evidence based practice is the key methodology which integrates the best research evidence, clinical expertise and patient need for a better outcome. To evaluate the factors that influence the application of evidence based physiotherapy in public and private sectors of Karachi, Pakistan.

Methodology: A cross-sectional survey was conducted from July to December 2017 in major physiotherapy clinics and rehabilitation centers of Karachi covering major government, semi-government and private sectors. Data was collected from 75 practicing physiotherapists through convenience sampling technique and were asked to fill self-administered close-ended questionnaire. Data entry and analysis was done using SPSS Version 16 and chi-square test applied.

Result: Lack of availability of resources to access information was noted to be the biggest practitioner barrier while disinterest in evidence based practice (EBP) was considered as the least important. Among various organizational barriers, lack of time provided by management and lack of support among physiotherapists were stated to be the biggest barriers. Perception of evidence based physiotherapy was noted to be generally positive among the physiotherapists. Graduates with experience of 1-5 years were found to be keener to refine their EBP skills and were more likely to agree that EBP integration with practical knowledge improved prognosis. Almost 70% well experienced (10 years +) physiotherapists were reported to have access to research publications whereas 80.4% fresh experienced said they were confident of their capability to search relevant research.

Conclusion: Individuals and organizations should work to rectify the identified barriers from this study and express learning in a way that helps them in applying research findings to ordinary patients in ordinary clinical settings.