This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Putnam, W.
Right arrow Articles by Cox, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Putnam, W.
Right arrow Articles by Cox, J. L.
Related Collections
Right arrow Other cardiovascular medicine
Right arrow Other evidence-based medicine
Right arrow Other family medicine
CMAJ • June 11, 2002; 166 (12)
© 2002 Canadian Medical Association or its licensors

Research
Recherche

A qualitative study of evidence in primary care: what the practitioners are saying

Wayne Putnam*, Peter L. Twohig*, Frederick I. Burge*, Lois A. Jackson{dagger} and Jafna L. Cox{ddagger}

*Department of Family Medicine, Dalhousie University, Halifax, NS; {dagger}School of Health and Human Performance, Dalhousie University, Halifax, NS; {ddagger}Division of Cardiology, Dalhousie University, Halifax, NS

Correspondence to: Dr. Wayne Putnam, Department of Family Medicine, Dalhousie University, Abbie J. Lane Building, 8th Floor, 5909 Veterans Memorial Lane, Halifax NS B3H 2E2; fax 902 496-4760; Wayne.Putnam@Dal.Ca

Background: Little is known about the impact of evidence-based medicine in primary care. Our objective was to explore the influence of evidence on day-to-day family practice, with specific reference to cardiovascular disease.

Methods: A total of 9 focus groups were conducted in rural, semi-urban and urban settings in Nova Scotia. The participants were 50 family physicians who had practised in their communities for more than 1 year and who were treating patients with cardiovascular disease.

Findings: Two major themes emerged: evidence in the clinical encounter and the culture of evidence. The family physicians reported thinking about evidence during the clinical encounter but still situated that evidence within the specific context of their patients and their communities. They appreciated evidence that had been appraised, summarized and published as a guideline by an independent national organization. Evidence remained in the forefront of consciousness for a limited time frame. Local specialists, trusted because of their previous successes with shared patient care, were important sources and interpreters of evidence.

Interpretation: Day-to-day family practice offers both obstacles and opportunities for the application of evidence. Although evidence is an important part of clinical practice, it is not absolute and is considered along with many other factors.




This article has been cited by other articles:


Home page
 cfpHome page
N. J.G. Pimlott, M. Persaud, N. Drummond, C. A. Cohen, J. L. Silvius, K. Seigel, G. R. Hollingworth, and W. B. Dalziel
Family physicians and dementia in Canada: Part 1. Clinical practice guidelines: awareness, attitudes, and opinions
Can Fam Physician, May 1, 2009; 55(5): 506 - 507.e5.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
N. L. Wilczynski
Quality of Reporting of Diagnostic Accuracy Studies: No Change Since STARD Statement Publication--Before-and-after Study
Radiology, September 1, 2008; 248(3): 817 - 823.
[Abstract] [Full Text] [PDF]

Home page
 Eval Health ProfHome page
M.-D. Beaulieu, M. Proulx, G. Jobin, M. Kugler, F. Gossard, J.-L. Denis, and D. Larouche
When Is Knowledge Ripe for Primary Care?: An Exploratory Study on the Meaning of Evidence
Eval Health Prof, March 1, 2008; 31(1): 22 - 42.
[Abstract] [PDF]

Home page
 JAMAHome page
D. M. Windish, S. J. Huot, and M. L. Green
Medicine Residents' Understanding of the Biostatistics and Results in the Medical Literature
JAMA, September 5, 2007; 298(9): 1010 - 1022.
[Abstract] [Full Text] [PDF]

Home page
 J Am Med Inform AssocHome page
R B. Haynes, J. Holland, C. Cotoi, R J. McKinlay, N. L Wilczynski, L. A Walters, D. Jedras, R. Parrish, K A. McKibbon, A. Garg, et al.
McMaster PLUS: A Cluster Randomized Clinical Trial of an Intervention to Accelerate Clinical Use of Evidence-based Information from Digital Libraries
JAMIA, November 1, 2006; 13(6): 593 - 600.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. B. Haynes, C. Cotoi, J. Holland, L. Walters, N. Wilczynski, D. Jedraszewski, J. McKinlay, R. Parrish, K. A. McKibbon, and for the McMaster Premium Literature Service (PLUS)
Second-order peer review of the medical literature for clinical practitioners.
JAMA, April 19, 2006; 295(15): 1801 - 1808.
[Abstract] [Full Text] [PDF]

Home page
 Int J Qual Health CareHome page
K. A. Lorenz, G. W. Ryan, S. C. Morton, K. S. Chan, S. Wang, and P. G. Shekelle
A qualitative examination of primary care providers' and physician managers' uses and views of research evidence
Int. J. Qual. Health Care, October 1, 2005; 17(5): 409 - 414.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Public HealthHome page
T. Meyer, A. Stroebel, and H. Raspe
Medical practitioners in outpatient care: who is interested in participating in EBM courses?: Results of a representative postal survey in Germany
Eur J Public Health, October 1, 2005; 15(5): 480 - 483.
[Abstract] [Full Text] [PDF]

Home page
 J Am Med Inform AssocHome page
N. B Giuse, T. Y Koonce, R. N Jerome, M. Cahall, N. A Sathe, and A. Williams
Evolution of a Mature Clinical Informationist Model
JAMIA, May 1, 2005; 12(3): 249 - 255.
[Abstract] [Full Text] [PDF]