Barriers To Evidence Use In Health Care Practice

Objectives: Research evidence is often under-utilised in dental practice and, therefore, optimal care may not be delivered routinely. This review is sought to identify barriers to evidence use in healthcare practice in general and to synthesise these thematically.
Methods: We were aware before commencing that systematic reviews of quantitative studies existed but we were not aware that qualitative studies had not been similarly synthesised. Thus, a combination of structured searching and the snowballing technique was used to identify systematic reviews of quantitative and/or qualitative studies and primary qualitative studies that sought to identify barriers to research use in practice. Electronic sources searched included: PubMed, The Cochrane Library and Google Scholar. The intention was not to prioritise any one barrier but to identify all the barriers documented in the literature.
Results: 15 studies were included - 3 systematic reviews, 1 ethnographic study and 11 primary studies). Most studies were quantitative with very few studies using observation, interviews and other qualitative methods such as ethnography. The barriers identified were synthesised into four themes, which were barriers related to: healthcare professionals’ knowledge and behaviour; patients’ preferences and practice context and the evidence itself. A number of barriers such as “time”, lacked sufficient description to understand the phenomenon in any depth.
Conclusions: A number of barriers to using research evidence in healthcare have been identified. A number of barriers require further qualitative exploration.