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Limited Evidence to Fully Determine the Implementation of Evidence-Based Practice by Healthcare Providers in Africa: A Systematic Review and Meta-Analysis.

作者信息

Astawesegn Feleke H, Ahmed Kedir Y, Thapa Subash, Mahmood Shakeel, Anyasodor Anayochukwu, Huda M Mamun, Aychilihum Setognal B, Modal Utpal K, Ross Allen G

机构信息

Rural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.

Hawassa University, Hawassa, Ethiopia.

出版信息

J Evid Based Med. 2025 Jun;18(2):e70032. doi: 10.1111/jebm.70032.


DOI:10.1111/jebm.70032
PMID:40375060
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12081785/
Abstract

AIM: Implementing evidence-based practice (EBP) is a complex process requiring healthcare providers to integrate evidence-based medicine (EBM) into clinical practice, ultimately improving clinical outcomes. This systematic review examined the sources of information for EBP, analyzed the extent of EBP implementation by healthcare providers, and explored the factors influencing EBP in Africa. METHODS: We identified articles published between January 1992 and March 2024 by searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMbase, PubMed, and Scopus databases. The pooled effect sizes for the prevalence of EBP and odds ratios (ORs) were estimated using random- and fixed-effects models as appropriate. For the qualitative component of the study, we performed a thematic analysis and subsequently integrated and interpreted findings from both the quantitative and qualitative analyses. RESULTS: Thirty-three studies were included in this review, involving 9722 healthcare providers: 60.3% nurses, 15.9% physicians, and 15.4% midwives. Our findings revealed a lack of detailed information on how healthcare providers utilized different forms of EBM to inform EBP and clinical outcomes in Africa. Self-reported EBP was 57.3% among nurses and 37.3% among physicians. Nigeria had the highest self-reported EBP (75.2%), whereas Egypt had the lowest (18.9%). Common sources of information reported for EBP were PubMed, UpToDate, the Cochrane Library, clinical guidelines, and training programs. Factors associated with EBP included knowledge of EBP (OR = 2.13, 95% confidence interval [CI]: 1.83-2.47), positive attitude toward EBP (OR = 1.95, 95% CI: 1.76-2.15), and having EBM training (OR = 3.08, 95% CI: 2.08-4.57), and a managerial role (OR = 2.16, 95% CI: 1.37-3.41). The availability of guidelines (OR = 1.88, 95% CI: 1.5-2.37) and internet access (OR = 1.90, 95% CI: 1.54-2.34) were also found to increase EBP. Our qualitative analysis identified common barriers to EBP, including a lack of support, resistance to change, poor communication, and failure to integrate EBP courses into the continuing education curricula. CONCLUSION: This systematic review found limited information on the sources of EBM, how it was delivered, and its frequency of use in clinical practice. Thus, the correlation between EBM, EBP, and clinical outcomes was not fully transparent. Further studies are required to examine the medical conditions addressed within providers' scopes of practice, the types of evidence utilized, the frequency and consistency of EBP implementation, and its effect on enhancing patient outcomes.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/7507a23f577f/JEBM-18-0-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/785f0b78e319/JEBM-18-0-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/23bac8ca1a55/JEBM-18-0-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/4ec23ebfe9c6/JEBM-18-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/7507a23f577f/JEBM-18-0-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/785f0b78e319/JEBM-18-0-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/23bac8ca1a55/JEBM-18-0-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/4ec23ebfe9c6/JEBM-18-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ef/12081785/7507a23f577f/JEBM-18-0-g002.jpg

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引用本文的文献

[1]
Attitudes and opinions of medical practitioners, librarians, and LIS academics towards health science library services to support evidence-based medical practice in South Africa.

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本文引用的文献

[1]
Evidence-based practice utilization and associated factors among nurses in the emergency department of selected public hospitals, Addis Ababa, Ethiopia, 2024: cross-sectional study.

BMC Health Serv Res. 2025-5-1

[2]
Evaluation of evidence-based medicine adoption among Nigerian surgeons: competence, knowledge, attitudes, practices, and barriers.

Croat Med J. 2024-2-29

[3]
Evidence-Based Practice and Its Associated Factors among Health Professionals Working at Public Hospitals in Southwest Ethiopia.

Biomed Res Int. 2023

[4]
Utilization of Evidence-Based Nursing Practice and Associated Factors Among Nurses Working in Saint Paul's Hospital Millennium Medical College, Ethiopia.

SAGE Open Nurs. 2023-11-22

[5]
Determinants of evidence-based practice among health care professionals in Ethiopia: A systematic review and meta-analysis.

PLoS One. 2023

[6]
Instruments to Assess Evidence-Based Practice Among Health Care Professionals: A Systematic Review.

Health Educ Behav. 2024-6

[7]
Evidence-based practice models and frameworks in the healthcare setting: a scoping review.

BMJ Open. 2023-5-22

[8]
Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review.

Hum Resour Health. 2023-3-20

[9]
Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review.

Worldviews Evid Based Nurs. 2023-2

[10]
Evidence-based practice utilisation and its associated factors among nurses working at public hospitals in West Shoa zone, central Ethiopia: a cross-sectional study.

BMJ Open. 2023-1-27

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