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UK trained osteopaths' relationship to evidence based practice - An analysis of influencing factors

      Highlights

      • The majority of osteopaths we surveyed displayed positive attitudes towards EBP.
      • Level of degree and years since graduation impacts on osteopaths' adoption of EBP.
      • Most osteopaths are guideline aware but only a minority utilise these in practice.
      • The greatest barrier to osteopaths using EBP in practice was perceived lack of time.

      Abstract

      Background

      Use of evidence based practice (EBP) remains controversial amongst UK osteopaths and developing an understanding of factors that influence EBP implementation is important for the profession. This study aimed to explore factors that influence the use of EBP amongst UK osteopaths and to compare these with other healthcare professionals.

      Design

      We used the JQ37 questionnaire to survey UK registered osteopaths (n = 2010). Logistic regression analyses measured associations between attitudes/beliefs, education, knowledge, EBP skills, and clinical guideline access with osteopaths' age, years since graduation, undergraduate and postgraduate degree level, attention to literature, and use of clinical guidelines.

      Results

      370 respondents (18.4%) completed the questionnaire: UK osteopaths generally had positive attitudes about EBP. They agreed that EBP was necessary, improved quality of care and assisted clinical decision-making. They also agreed that literature/research findings were useful in their practice and were interested in learning/improving EBP skills necessary to incorporate EBP into practice. Critical appraisal, professional database use, training and familiarity with search strategies were positively associated with younger osteopaths and those with higher levels of degree, or held a research or educational position in addition to clinical practice. Perceived barriers to utilising EBP were lack of time, inapplicability and uniqueness of their osteopathic patient population.

      Discussion and conclusion

      Generally UK osteopaths had positive attitudes about EBP and interested in improving skills needed to implement EBP into practice. However, respondents did not search or use available online practice guidelines, believing guidelines were inapplicable to osteopathic patients, who were unique.

      Keywords

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      References

        • Sackett D.L.
        • Rosenberg W.M.C.
        • Gray J. a M.
        • Haynes R.B.
        • Richardson W.S.
        Evidence based medicine: what it is and what it isn’t.
        Br Med J. 1996; 312: 71-72https://doi.org/10.1136/bmj.312.7023.71
        • Guyatt G.H.
        • Haynes R.B.
        • Jaeschke R.Z.
        • Cook D.J.
        • Green L.
        • Naylor C.D.
        • et al.
        Users’ guides to the medical literature.
        J Am Med Assoc. 2000; 284: 1290https://doi.org/10.1001/jama.284.10.1290
        • Kim Y.N.
        • Cho S.H.
        A survey of complementary and alternative medicine practitioner’s perceptions of evidence-based medicine.
        Eur J Integr Med. 2014; 6: 211-219https://doi.org/10.1016/j.eujim.2013.11.001
        • Woo J.M.
        • Cho S.-H.
        Traditional Korean medicine practitioners? attitudes toward evidence based medicine: a qualitative study.
        Eur J Integr Med. 2012; 4: e448-e454https://doi.org/10.1016/j.eujim.2012.09.004
        • Hadley J.
        • Hassan I.
        • Khan K.S.
        Knowledge and beliefs concerning evidence-based practice amongst complementary and alternative medicine health care practitioners and allied health care professionals: a questionnaire survey.
        BMC Compl Alternative Med. 2008; 8: 45https://doi.org/10.1186/1472-6882-8-45
        • Maaskant J.M.
        • Knops A.M.
        • Ubbink D.T.
        • Vermeulen H.
        Evidence-based practice: a survey among pediatric nurses and pediatricians.
        J Pediatr Nurs. 2013; 28: 150-157https://doi.org/10.1016/j.pedn.2012.05.002
        • McInerney P.
        • Suleman F.
        Exploring knowledge, attitudes, and barriers toward the use of evidence-based practice amongst academic health care practitioners in their teaching in a South African university: a pilot study.
        Worldviews Evidence-Based Nurs. 2010; 7: 90-97https://doi.org/10.1111/j.1741-6787.2009.00180.x
        • Kuhn G.J.
        • Wyer P.C.
        • Cordell W.H.
        • Rowe B.H.
        A survey to determine the prevalence and characteristics of training in evidence-based medicine in emergency medicine residency programs.
        J Emerg Med. 2005; 28: 353-359https://doi.org/10.1016/j.jemermed.2004.09.015
        • Iles R.
        • Davidson M.
        Evidence based practice: a survey of physiotherapists’ current practice.
        Physiother Res Int. 2006; 11: 93-103https://doi.org/10.1002/pri.328
        • Jette D.U.
        • Bacon K.
        • Batty C.
        • Carlson M.
        • Ferland A.
        • Hemingway R.D.
        • et al.
        Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists.
        Phys Ther. 2003; 83: 786-805
        • Walker B.F.
        • Stomski N.J.
        • Hebert J.J.
        • French S.D.
        A survey of Australian chiropractors’ attitudes and beliefs about evidence-based practice and their use of research literature and clinical practice guidelines.
        Chiropr Man Ther. 2013; 21: 44https://doi.org/10.1186/2045-709X-21-44
        • Upton D.
        • Upton P.
        Knowledge and use of evidence-based practice of GPs and hospital doctors.
        J Eval Clin Pract. 2006; 12: 376-384https://doi.org/10.1111/j.1365-2753.2006.00602.x
        • Young J.M.
        • Ward J.E.
        Evidence-based medicine in general practice: beliefs and barriers among Australian GPs.
        J Eval Clin Pract. 2001; 7: 201-210https://doi.org/10.1046/j.1365-2753.2001.00294.x
        • Leach M.J.
        • Gillham D.
        Are complementary medicine practitioners implementing evidence based practice?.
        Compl Ther Med. 2011; 19: 128-136https://doi.org/10.1016/j.ctim.2011.04.002
        • Sutcliffe P.
        • Clar C.
        • Tsertsvadze A.
        • Briscoe S.
        • Clarke A.
        Clinical and cost-effectiveness of manual therapy for the management of a variety of musculoskeletal and non-musculoskeletal conditions: a systematic review.
        2013
        • Fryer G.
        Teaching critical thinking in osteopathy - integrating craft knowledge and evidence-informed approaches.
        Int J Osteopath Med. 2008; 11: 56-61https://doi.org/10.1016/j.ijosm.2008.02.005
        • Humpage C.
        Opinions on research and evidence based medicine within the UK osteopathic profession: a thematic analysis of public documents 2003-2009.
        Int J Osteopath Med. 2011; 14: 48-56https://doi.org/10.1016/j.ijosm.2010.11.005
        • Estabrooks C.A.
        • Floyd J.A.
        • Scott-Findlay S.
        • O’Leary K.A.
        • Gushta M.
        Individual determinants of research utilization: a systematic review.
        J Adv Nurs. 2003; 43: 506-520https://doi.org/10.1046/j.1365-2648.2003.02748.x
        • Heiwe S.
        • Kajermo K.N.
        • Tyni-Lenne R.
        • Guidetti S.
        • Samuelsson M.
        • Andersson I.-L.
        • et al.
        Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals.
        Int J Qual Health Care. 2011; 23: 198-209https://doi.org/10.1093/intqhc/mzq083
        • McClernon F.J.
        • Yancy W.S.
        • Eberstein J.A.
        • Atkins R.C.
        • Westman E.C.
        • Bianco A.
        • et al.
        The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms*.
        Obesity. 2007; 15 (182–182)https://doi.org/10.1038/oby.2007.516
        • General Osteopathic Council
        Recognised qualifications. London.
        2015
      1. UK Government. What qualification levels mean: England, Wales and Northern Ireland - GOV.UK n.d. https://www.gov.uk/what-different-qualification-levels-mean/list-of-qualification-levels (accessed August 24, 2017).

        • Bennett S.
        • Tooth L.
        • McKenna K.
        • Rodger S.
        • Strong J.
        • Ziviani J.
        • et al.
        Perceptions of evidence-based practice: a survey of Australian occupational therapists.
        Aust Occup Ther J. 2003; 50: 13-22https://doi.org/10.1046/j.1440-1630.2003.00341.x
        • O’Donnell C.A.
        Attitudes and knowledge of primary care professionals towards evidence-based practice: a postal survey.
        J Eval Clin Pract. 2004; 10: 197-205https://doi.org/10.1111/j.1365-2753.2003.00458.x
        • Salbach N.M.
        • Jaglal S.B.
        • Korner-Bitensky N.
        • Rappolt S.
        • Davis D.
        Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke.
        Phys Ther. 2007; 87: 1284-1303https://doi.org/10.2522/ptj.20070040
        • Ramírez-Vélez R.
        • Médica C.
        • Correa-Bautista J.E.
        • Muñoz-Rodríguez D.I.
        • Ramírez L.
        • González-Ruíz K.
        • et al.
        Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists.
        Colomb Méd. 2015; 46: 33-40
        • Akinbo S.R.A.
        • Odebiyi do
        • Okunola T.E.
        • Aderoba O.T.
        Evidence-based practice: knowledge, attitudes and beliefs of physiotherapists in Nigeria - ISPUB.
        Internet J Med Inf. 2009; 4: 1-8
        • Al-Ansary L.A.
        • Khoja T.A.
        The place of evidence-based medicine among primary health care physicians in Riyadh region.
        Saudi Arabia. Fam Pract. 2002; 19: 537-542https://doi.org/10.1093/FAMPRA/19.5.537
        • McColl A.
        • Smith H.
        • White P.
        • Field J.
        General practitioner’s perceptions of the route to evidence based medicine: a questionnaire survey.
        BMJ. 1998; 316: 361-365https://doi.org/10.1136/bmj.316.7128.361
        • Young J.M.
        • Ward J.E.
        Evidence-based medicine in general practice: beliefs and barriers among Australian GPs.
        J Eval Clin Pract. 2001; 7: 201-210
        • Heiwe S.
        • Kajermo K.N.
        • Tyni-Lenne R.
        • Guidetti S.
        • Samuelsson M.
        • Andersson I.-L.
        • et al.
        Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals.
        Int J Qual Health Care. 2011; 23: 198-209https://doi.org/10.1093/intqhc/mzq083
        • O’Donnell C.A.
        Attitudes and knowledge of primary care professionals towards evidence-based practice: a postal survey.
        J Eval Clin Pract. 2004; 10: 197-205https://doi.org/10.1111/j.1365-2753.2003.00458.x
        • MacEwan Dysart A.
        • Tomlin G.S.
        Factors related to evidence-based practice among U.S. occupational therapy clinicians.
        Am J Occup Ther. 2002; 56: 275-284https://doi.org/10.5014/ajot.56.3.275
        • Kamwendo K.
        What do Swedish physiotherapists feel about research? A survey of perceptions, attitudes, intentions and engagement.
        Physiother Res Int. 2002; 7: 23-34https://doi.org/10.1002/pri.238
        • Grimmer-Somers K.
        • Lekkas P.
        • Nyland L.
        • Young A.
        • Kumar S.
        Perspectives on research evidence and clinical practice: a survey of Australian physiotherapists.
        Physiother Res Int. 2007; 12: 147-161https://doi.org/10.1002/pri.363
        • Madhavji A.
        • Araujo E.A.
        • Kim K.B.
        • Buschang P.H.
        Attitudes, awareness, and barriers toward evidence-based practice in orthodontics.
        Am J Orthod Dentofacial Orthop. 2011; 140: 309-316https://doi.org/10.1016/j.ajodo.2010.05.023
        • Nilsagård Y.
        • Lohse G.
        • Nilsagård Y.
        • Lohse G.
        Evidence-based physiotherapy: a survey of knowledge, behaviour, attitudes and prerequisites.
        Adv Physiother. 2010; 12: 179-186https://doi.org/10.3109/14038196.2010.503812
        • Darlow B.
        • Fullen B.M.
        • Dean S.
        • Hurley D.A.
        • Baxter G.D.
        • Dowell A.
        The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review.
        Eur J Pain. 2012; 16: 3-17https://doi.org/10.1016/j.ejpain.2011.06.006
        • Ross L.
        • Ward A.
        Naive realism in everyday life: implications for social conflict and misunderstanding.
        in: Reed E.S. Turiel E. Brown T. Values knowl. Lawrence Erlbaum Associates, Inc., New Jersey1996: 103-136
        • Nickerson R.S.
        Confirmation bias: a ubiquitous phenomenon in many guises.
        Rev Gen Psychol. 1998; 2: 175-220https://doi.org/10.1037/1089-2680.2.2.175
        • Munro G.D.
        • Ditto P.H.
        Biased assimilation, attitude polarization, and affect in reactions to stereotype-relevant scientific information.
        Pers Soc Psychol Bull. 1997; 23: 636-653https://doi.org/10.1177/0146167297236007
        • Kunda Z.
        The case for motivated reasoning.
        Psychol Bull. 1990; 108: 480-498
        • Stark J.E.
        An historical perspective on principles of osteopathy.
        Int J Osteopath Med. 2013; 16: 3-10https://doi.org/10.1016/j.ijosm.2012.10.001
        • Thomson O.P.
        • Petty N.J.
        • Moore A.P.
        A qualitative grounded theory study of the conceptions of clinical practice in osteopathy ? A continuum from technical rationality to?professional artistry.
        Man Ther. 2014; 19: 37-43https://doi.org/10.1016/j.math.2013.06.005
        • Kasiri-Martino H.
        • Bright P.
        Osteopathic educators’ attitudes towards osteopathic principles and their application in clinical practice: a qualitative inquiry.
        Man Ther. 2016; 21: 233-240https://doi.org/10.1016/j.math.2015.09.003
        • Figg-Latham J.
        • Rajendran D.
        Quiet dissent: the attitudes, beliefs and behaviours of UK osteopaths who reject low back pain guidance - a qualitative study.
        Man Ther. 2016; https://doi.org/10.1016/j.math.2016.10.006
        • Jette D.U.
        • Bacon K.
        • Batty C.
        • Ferland A.
        • Hemingway R.D.
        • Hill J.C.
        • et al.
        Research report evidence-based Practice : beliefs, attitudes, knowledge, and behaviors.
        Phys Ther J. 2003; : 83
        • Kajermo K.N.
        • Nordstrom G.
        • Krusebrant A.
        • Bjorvell H.
        Barriers to and facilitators of research utilization, as perceived by a group of registered nurses in Sweden.
        J Adv Nurs. 1998; 27: 798-807https://doi.org/10.1046/j.1365-2648.1998.00614.x
        • General Osteopathic Council
        Countdown to new CPD.
        Osteopat Mag. 2017; 20: 12-14https://doi.org/10.1002/9780470690314
        • Guerra J.
        • Bagur C.
        • Girabent M.
        Adaptación al castellano y validación del cuestionario sobre práctica basada en la evidencia en fisioterapeutas.
        Fisioterapia. 2012; 34: 65-72https://doi.org/10.1016/j.ft.2011.10.003
        • Kang H.
        The prevention and handling of the missing data.
        Korean J Anesthesiol. 2013; 64: 402-406https://doi.org/10.4097/kjae.2013.64.5.402