‘What scientific evidence supports this?’ how do physiotherapists in private practice use evidence-based practice and what are the main challenges? A convergent parallel mixed-methods study

Abstract

Purpose

Evidence-based practice (EBP) has been defined as the integration of best available scientific evidence, patient preferences, and individual clinical expertise. A range of barriers for implementing EBP in physiotherapy practice have been identified, but little is known about the underlying causes. The objective was to explore how physiotherapists in private practice perceive EBP, how they use, and what their main challenges are.

Materials and methods

This study used a convergent parallel mixed-methods design. It consisted of a 28-item questionnaire informed by systematic reviews with a deductive approach and semi-structured interviews with a phenomenological and inductive approach.

Results

The results from the questionnaire (n = 216) and the interviews (n = 9) showed that physiotherapists are more likely to implement EBP if they have sufficient flexibility in time allocation to facilitate shared decision-making and increase the integration of patient preferences. Support from colleagues and the workplace culture were identified as both a challenge and a potential facilitator for increased use of EBP.

Conclusion

Participants in this study experienced several modifiable challenges, including lack of flexibility in time allocation and insufficient time to build rapport with the patient. Physiotherapists show inconsistency in their understanding of what EBP is – this ultimately becomes an additional and yet undescribed barrier for implementation of EBP.

Keywords:

• Evidence-based practice
• physiotherapy
• clinical practice
• patient preferences
• scientific evidence
• clinical expertise

Disclosure statement and sources of funding

No potential conflict of interest was reported by the author(s).

Disclosure statement

None

Acknowledgements

None

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. MH has received support from non-industrial professional, private and scientific bodies (reimbursement of travel costs and speaker fees) for lectures on pain, and he receives book royalties from Gyldendal, Munksgaard Denmark, FADL and Muusmann publications. There was no specific funding obtained for this study.