Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide crosssectional study

Aim To determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. Methods A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n = 496) and rural (n = 482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Results Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician’s opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P < 0.001 for both). Conclusion Our finding that patients consider a physician’s opinion to be the most reliable source of healthrelated information could be used for promotion of highquality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary

Knowledge and use of information on evidence-based medicine among patients and family medicine physicians in Croatia

Cilj: Mali broj istraživanja posvećen je ulozi medicine utemeljene na dokazima (engl. evidencebased medicine, EBM) u zdravstvenom sustavu Republike Hrvatske. Ova doktorska disertacija uključila je dva istraživanja. Prvo istraživanje bilo je presječno istraživanje o informiranosti, stavovima, poznavanju i korištenju informacija o medicini utemeljenoj na dokazima među pacijentima u Hrvatskoj. Drugo istraživanje bilo je presječno istraživanje o razini informiranosti, stavovima, poznavanju, korištenju informacija i preprekama u primjeni EBM-a među liječnicima obiteljske medicine, s ili bez specijalizacije. Metode: U prvom istraživanju, sudjelovalo je 978 pacijenata iz 10 ordinacija obiteljske medicine iz 5 hrvatskih regija (po jedna ordinacija iz urbane i ruralne sredine). Istraživanje je provedeno od rujna 2014. do rujna 2015. godine te je za potrebe njegovog provođenja korišten posebno pripremljen upitnik s 27 pitanja. Pacijenti su upitani o njihovoj aktivnosti u potrazi za dodatnim informacijama o svojoj terapiji i/ili dijagnozi, o korištenju raznih izvora medicinskih informacija, njihovom poznavanju EBM-a, sustavnih pregleda, o Cochraneovoj knjižnici, o Hrvatskom Cochraneu te čitaju li Cochraneove laičke sažetke pripremljene na hrvatskom jeziku. Prikupljeni su i njihovi sociodemografski podaci, uključujući profesionalni status, stupanj obrazovanja, spol i dob. U drugom istraživanju sudjelovali su hrvatski liječnici obiteljske medicine. Ispitanici su bili uključeni na dva načina: za vrijeme trajanja tečajeva trajne medicinske izobrazbe namijenjenih liječnicima obiteljske medicine ispunjavajući tiskanu verzija upitnika, ili su sudjelovali u istraživanju elektroničkim putem, popunjavanjem online verzije upitnika. Istraživanje je bilo provedeno od travnja do rujna 2016. godine. U istraživanju je korišten standardizirani upitnik o EBM-u, koji je proširen sa sociodemografskim pitanjima i pitanjima o radu liječnika koja su prilagođena hrvatskom zdravstvenom sustavu. Svaki ispitanik je samostalno procjenjivao razinu poznavanja i razumijevanja EBM pojmova. Rezultati: U prvom istraživanju, više od polovice pacijenata aktivno traži medicinske informacije iz drugih izvora, izuzev liječnika. Internet je bio najčešće mjesto na kojem su pacijenti tražili informacije, pretražujući informacije putem popularnih tražilica. Vrlo je mali broj pacijenata koji su koristili EBM izvore za informiranje o zdravlju, dok je tek jedna petina 90 pacijenata čula za EBM, a samo 4% pacijenata čulo je za Cochrane kolaboraciju. Pacijenti smatraju liječničko mišljenje najpouzdanijim izvorom medicinskih informacija. Model logističke regresije pokazao je da su stupanj obrazovanja i mjesto prebivališta (urbano naspram ruralno) prediktori svijesti o EBM-u i sustavnim pregledima (P <0,001 za oboje). U drugom istraživanju, 295 (14%) od svih službeno registriranih liječnika obiteljske medicine je odgovorilo na upitnik. Ispitanici su izrazili vrlo pozitivan stav prema promociji i korištenju EBM-a u svojoj praksi. 160 (67%) liječnika navelo je da nemaju pristup Cochraneovoj knjižnici. Što se tiče prepreka u korištenju EBM-a, većina je izjavila da nema dovoljno vremena za pronalaženje dokaza (80%) te su prijavili kako nerealna očekivanja pacijenata utječu na odabir liječenja (72%). Između dvije skupine liječnika, onih s ili bez specijalizacije, specijalisti obiteljske medicine učestalije su prijavili nedostatak vremena kao ograničenje za traženje dokaza. Najviša razina samoprocijenjenog razumijevanja EBM terminologije uočena je za pojmove ustroja istraživanja, a najniža za statističke pojmove. Zaključak: Prvo istraživanje pokazalo je da pacijenti smatraju mišljenje liječnika najpouzdanijim izvorom zdravstvenih informacija. Ova činjenica bi se trebala iskoristiti za promicanje visokokvalitetnih zdravstvenih informacija među pacijentima. Više truda trebalo bi posvetiti edukaciji pacijenata u ruralnim područjima i onih s nižim stupnjem obrazovanja. Nužno je potražiti dodatne aktivnosti i načine za prevođenje znanja i širenje EBM-a među pacijentima. Drugo istraživanje pokazalo je da liječnici obiteljske medicine u Hrvatskoj imaju vrlo pozitivne stavove prema korištenju EBM-a. Složili su se da EBM poboljšava skrb o pacijentima, a procijenili su da se više od dvije trećine njihove prakse temelji na EBM-u. U usporedbi s rezultatima prethodnog istraživanja među liječnicima iz 2010. godine, došlo je do određenog povećanja razine svijesti o EBM-u. Međutim, za daljnje povećanje kvalitete EBM prakse u Hrvatskoj potrebni su bolji pristup izvorima EBM i daljnje obrazovne aktivnosti Hrvatskog Cochranea.Objective: Few studies were explored the role of evidence-based medicine (EBM) in the health system of the Republic of Croatia. This doctoral dissertation included two studies. The first study was a cross-sectional study on information, attitudes, knowledge and use of information on evidence-based medicine among patients in Croatia. The second study was a cross-sectional survey on the level of information, attitudes, knowledge, use of information and barriers to the application of EBM among family physicians, with or without specialization. Study design: In the first study, 978 patients from 10 family medicine practices from 5 Croatian regions (one practice from urban and one from rural areas) participated. The survey was conducted from September 2014 to September 2015, and a specially prepared questionnaire with 27 questions was used. Patients were asked about their activity in searching for additional information about their therapy and/or diagnosis, about using various sources of medical information, their knowledge of EBM, systematic reviews, about the Cochrane Library, about Cochrane Croatia and whether they read Cochrane plain language summaries prepared in Croatian language. Their sociodemographic data were also collected, including professional status, education level, gender and age. Croatian family physicians participated in the second cross-sectional study. Respondents were involved in two ways: during the continuing medical education courses for family physicians by filling out a printed version of the questionnaire, or they participated in the survey electronically, by using an online version of the questionnaire. The survey was conducted from April to September 2016. The study used a standardized questionnaire on EBM, which was expanded with socio-demographic questions and questions about the work of physicians that are adapted to the Croatian health system. Each respondent independently assessed the level of knowledge and understanding of EBM concepts. Results: Regarding the first study, half of the patients searched for the medical information from sources other than physician. Internet was the most common place they searched for 92 information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician’s opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs. rural residence were the predictors of awareness about EBM and systematic reviews (P < 0.001 for both). In the second study, 295 (14%) of all officially registered family physicians responded to the questionnaire. Respondents were very positive toward the promotion and usage of EBM. 160 (67%) indicated that they did not have access to the Cochrane Library. The majority reported lack of time available for finding evidence (80%), and patients’ unrealistic expectations that influence physicians’ choice of treatment (72%). Between the two groups of physicians, family medicine specialists more frequently reported time as barrier for finding evidence. The highest level of EBM terminology understanding was reported for study design terms, and the lowest for statistical terms. Conclusion: Our findings from the first study showed that patients consider a physician’s opinion to be the most reliable source of health related information which should be used for promotion of high quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary. The second study demonstrated that family physicians in Croatia had very positive attitudes toward the use of EBM, they agreed that EBM improves patient care, and they estimated that more than two thirds of their practice is EBM-based. Compared to the results of the previous survey of physicians in Croatia in 2010, there was some increase in the level of EBM awareness among family physicians. However, to further increase the quality of EBM practice in Croatia better access to EBM sources and further educational activities of Cochrane Croatia are needed

Knowledge and use of information on evidence-based medicine among patients and family medicine physicians in Croatia

Cilj: Mali broj istraživanja posvećen je ulozi medicine utemeljene na dokazima (engl. evidencebased medicine, EBM) u zdravstvenom sustavu Republike Hrvatske. Ova doktorska disertacija uključila je dva istraživanja. Prvo istraživanje bilo je presječno istraživanje o informiranosti, stavovima, poznavanju i korištenju informacija o medicini utemeljenoj na dokazima među pacijentima u Hrvatskoj. Drugo istraživanje bilo je presječno istraživanje o razini informiranosti, stavovima, poznavanju, korištenju informacija i preprekama u primjeni EBM-a među liječnicima obiteljske medicine, s ili bez specijalizacije. Metode: U prvom istraživanju, sudjelovalo je 978 pacijenata iz 10 ordinacija obiteljske medicine iz 5 hrvatskih regija (po jedna ordinacija iz urbane i ruralne sredine). Istraživanje je provedeno od rujna 2014. do rujna 2015. godine te je za potrebe njegovog provođenja korišten posebno pripremljen upitnik s 27 pitanja. Pacijenti su upitani o njihovoj aktivnosti u potrazi za dodatnim informacijama o svojoj terapiji i/ili dijagnozi, o korištenju raznih izvora medicinskih informacija, njihovom poznavanju EBM-a, sustavnih pregleda, o Cochraneovoj knjižnici, o Hrvatskom Cochraneu te čitaju li Cochraneove laičke sažetke pripremljene na hrvatskom jeziku. Prikupljeni su i njihovi sociodemografski podaci, uključujući profesionalni status, stupanj obrazovanja, spol i dob. U drugom istraživanju sudjelovali su hrvatski liječnici obiteljske medicine. Ispitanici su bili uključeni na dva načina: za vrijeme trajanja tečajeva trajne medicinske izobrazbe namijenjenih liječnicima obiteljske medicine ispunjavajući tiskanu verzija upitnika, ili su sudjelovali u istraživanju elektroničkim putem, popunjavanjem online verzije upitnika. Istraživanje je bilo provedeno od travnja do rujna 2016. godine. U istraživanju je korišten standardizirani upitnik o EBM-u, koji je proširen sa sociodemografskim pitanjima i pitanjima o radu liječnika koja su prilagođena hrvatskom zdravstvenom sustavu. Svaki ispitanik je samostalno procjenjivao razinu poznavanja i razumijevanja EBM pojmova. Rezultati: U prvom istraživanju, više od polovice pacijenata aktivno traži medicinske informacije iz drugih izvora, izuzev liječnika. Internet je bio najčešće mjesto na kojem su pacijenti tražili informacije, pretražujući informacije putem popularnih tražilica. Vrlo je mali broj pacijenata koji su koristili EBM izvore za informiranje o zdravlju, dok je tek jedna petina 90 pacijenata čula za EBM, a samo 4% pacijenata čulo je za Cochrane kolaboraciju. Pacijenti smatraju liječničko mišljenje najpouzdanijim izvorom medicinskih informacija. Model logističke regresije pokazao je da su stupanj obrazovanja i mjesto prebivališta (urbano naspram ruralno) prediktori svijesti o EBM-u i sustavnim pregledima (P <0,001 za oboje). U drugom istraživanju, 295 (14%) od svih službeno registriranih liječnika obiteljske medicine je odgovorilo na upitnik. Ispitanici su izrazili vrlo pozitivan stav prema promociji i korištenju EBM-a u svojoj praksi. 160 (67%) liječnika navelo je da nemaju pristup Cochraneovoj knjižnici. Što se tiče prepreka u korištenju EBM-a, većina je izjavila da nema dovoljno vremena za pronalaženje dokaza (80%) te su prijavili kako nerealna očekivanja pacijenata utječu na odabir liječenja (72%). Između dvije skupine liječnika, onih s ili bez specijalizacije, specijalisti obiteljske medicine učestalije su prijavili nedostatak vremena kao ograničenje za traženje dokaza. Najviša razina samoprocijenjenog razumijevanja EBM terminologije uočena je za pojmove ustroja istraživanja, a najniža za statističke pojmove. Zaključak: Prvo istraživanje pokazalo je da pacijenti smatraju mišljenje liječnika najpouzdanijim izvorom zdravstvenih informacija. Ova činjenica bi se trebala iskoristiti za promicanje visokokvalitetnih zdravstvenih informacija među pacijentima. Više truda trebalo bi posvetiti edukaciji pacijenata u ruralnim područjima i onih s nižim stupnjem obrazovanja. Nužno je potražiti dodatne aktivnosti i načine za prevođenje znanja i širenje EBM-a među pacijentima. Drugo istraživanje pokazalo je da liječnici obiteljske medicine u Hrvatskoj imaju vrlo pozitivne stavove prema korištenju EBM-a. Složili su se da EBM poboljšava skrb o pacijentima, a procijenili su da se više od dvije trećine njihove prakse temelji na EBM-u. U usporedbi s rezultatima prethodnog istraživanja među liječnicima iz 2010. godine, došlo je do određenog povećanja razine svijesti o EBM-u. Međutim, za daljnje povećanje kvalitete EBM prakse u Hrvatskoj potrebni su bolji pristup izvorima EBM i daljnje obrazovne aktivnosti Hrvatskog Cochranea.Objective: Few studies were explored the role of evidence-based medicine (EBM) in the health system of the Republic of Croatia. This doctoral dissertation included two studies. The first study was a cross-sectional study on information, attitudes, knowledge and use of information on evidence-based medicine among patients in Croatia. The second study was a cross-sectional survey on the level of information, attitudes, knowledge, use of information and barriers to the application of EBM among family physicians, with or without specialization. Study design: In the first study, 978 patients from 10 family medicine practices from 5 Croatian regions (one practice from urban and one from rural areas) participated. The survey was conducted from September 2014 to September 2015, and a specially prepared questionnaire with 27 questions was used. Patients were asked about their activity in searching for additional information about their therapy and/or diagnosis, about using various sources of medical information, their knowledge of EBM, systematic reviews, about the Cochrane Library, about Cochrane Croatia and whether they read Cochrane plain language summaries prepared in Croatian language. Their sociodemographic data were also collected, including professional status, education level, gender and age. Croatian family physicians participated in the second cross-sectional study. Respondents were involved in two ways: during the continuing medical education courses for family physicians by filling out a printed version of the questionnaire, or they participated in the survey electronically, by using an online version of the questionnaire. The survey was conducted from April to September 2016. The study used a standardized questionnaire on EBM, which was expanded with socio-demographic questions and questions about the work of physicians that are adapted to the Croatian health system. Each respondent independently assessed the level of knowledge and understanding of EBM concepts. Results: Regarding the first study, half of the patients searched for the medical information from sources other than physician. Internet was the most common place they searched for 92 information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician’s opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs. rural residence were the predictors of awareness about EBM and systematic reviews (P < 0.001 for both). In the second study, 295 (14%) of all officially registered family physicians responded to the questionnaire. Respondents were very positive toward the promotion and usage of EBM. 160 (67%) indicated that they did not have access to the Cochrane Library. The majority reported lack of time available for finding evidence (80%), and patients’ unrealistic expectations that influence physicians’ choice of treatment (72%). Between the two groups of physicians, family medicine specialists more frequently reported time as barrier for finding evidence. The highest level of EBM terminology understanding was reported for study design terms, and the lowest for statistical terms. Conclusion: Our findings from the first study showed that patients consider a physician’s opinion to be the most reliable source of health related information which should be used for promotion of high quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary. The second study demonstrated that family physicians in Croatia had very positive attitudes toward the use of EBM, they agreed that EBM improves patient care, and they estimated that more than two thirds of their practice is EBM-based. Compared to the results of the previous survey of physicians in Croatia in 2010, there was some increase in the level of EBM awareness among family physicians. However, to further increase the quality of EBM practice in Croatia better access to EBM sources and further educational activities of Cochrane Croatia are needed

Knowledge and use of information on evidence-based medicine among patients and family medicine physicians in Croatia

Cilj: Mali broj istraživanja posvećen je ulozi medicine utemeljene na dokazima (engl. evidencebased medicine, EBM) u zdravstvenom sustavu Republike Hrvatske. Ova doktorska disertacija uključila je dva istraživanja. Prvo istraživanje bilo je presječno istraživanje o informiranosti, stavovima, poznavanju i korištenju informacija o medicini utemeljenoj na dokazima među pacijentima u Hrvatskoj. Drugo istraživanje bilo je presječno istraživanje o razini informiranosti, stavovima, poznavanju, korištenju informacija i preprekama u primjeni EBM-a među liječnicima obiteljske medicine, s ili bez specijalizacije. Metode: U prvom istraživanju, sudjelovalo je 978 pacijenata iz 10 ordinacija obiteljske medicine iz 5 hrvatskih regija (po jedna ordinacija iz urbane i ruralne sredine). Istraživanje je provedeno od rujna 2014. do rujna 2015. godine te je za potrebe njegovog provođenja korišten posebno pripremljen upitnik s 27 pitanja. Pacijenti su upitani o njihovoj aktivnosti u potrazi za dodatnim informacijama o svojoj terapiji i/ili dijagnozi, o korištenju raznih izvora medicinskih informacija, njihovom poznavanju EBM-a, sustavnih pregleda, o Cochraneovoj knjižnici, o Hrvatskom Cochraneu te čitaju li Cochraneove laičke sažetke pripremljene na hrvatskom jeziku. Prikupljeni su i njihovi sociodemografski podaci, uključujući profesionalni status, stupanj obrazovanja, spol i dob. U drugom istraživanju sudjelovali su hrvatski liječnici obiteljske medicine. Ispitanici su bili uključeni na dva načina: za vrijeme trajanja tečajeva trajne medicinske izobrazbe namijenjenih liječnicima obiteljske medicine ispunjavajući tiskanu verzija upitnika, ili su sudjelovali u istraživanju elektroničkim putem, popunjavanjem online verzije upitnika. Istraživanje je bilo provedeno od travnja do rujna 2016. godine. U istraživanju je korišten standardizirani upitnik o EBM-u, koji je proširen sa sociodemografskim pitanjima i pitanjima o radu liječnika koja su prilagođena hrvatskom zdravstvenom sustavu. Svaki ispitanik je samostalno procjenjivao razinu poznavanja i razumijevanja EBM pojmova. Rezultati: U prvom istraživanju, više od polovice pacijenata aktivno traži medicinske informacije iz drugih izvora, izuzev liječnika. Internet je bio najčešće mjesto na kojem su pacijenti tražili informacije, pretražujući informacije putem popularnih tražilica. Vrlo je mali broj pacijenata koji su koristili EBM izvore za informiranje o zdravlju, dok je tek jedna petina 90 pacijenata čula za EBM, a samo 4% pacijenata čulo je za Cochrane kolaboraciju. Pacijenti smatraju liječničko mišljenje najpouzdanijim izvorom medicinskih informacija. Model logističke regresije pokazao je da su stupanj obrazovanja i mjesto prebivališta (urbano naspram ruralno) prediktori svijesti o EBM-u i sustavnim pregledima (P <0,001 za oboje). U drugom istraživanju, 295 (14%) od svih službeno registriranih liječnika obiteljske medicine je odgovorilo na upitnik. Ispitanici su izrazili vrlo pozitivan stav prema promociji i korištenju EBM-a u svojoj praksi. 160 (67%) liječnika navelo je da nemaju pristup Cochraneovoj knjižnici. Što se tiče prepreka u korištenju EBM-a, većina je izjavila da nema dovoljno vremena za pronalaženje dokaza (80%) te su prijavili kako nerealna očekivanja pacijenata utječu na odabir liječenja (72%). Između dvije skupine liječnika, onih s ili bez specijalizacije, specijalisti obiteljske medicine učestalije su prijavili nedostatak vremena kao ograničenje za traženje dokaza. Najviša razina samoprocijenjenog razumijevanja EBM terminologije uočena je za pojmove ustroja istraživanja, a najniža za statističke pojmove. Zaključak: Prvo istraživanje pokazalo je da pacijenti smatraju mišljenje liječnika najpouzdanijim izvorom zdravstvenih informacija. Ova činjenica bi se trebala iskoristiti za promicanje visokokvalitetnih zdravstvenih informacija među pacijentima. Više truda trebalo bi posvetiti edukaciji pacijenata u ruralnim područjima i onih s nižim stupnjem obrazovanja. Nužno je potražiti dodatne aktivnosti i načine za prevođenje znanja i širenje EBM-a među pacijentima. Drugo istraživanje pokazalo je da liječnici obiteljske medicine u Hrvatskoj imaju vrlo pozitivne stavove prema korištenju EBM-a. Složili su se da EBM poboljšava skrb o pacijentima, a procijenili su da se više od dvije trećine njihove prakse temelji na EBM-u. U usporedbi s rezultatima prethodnog istraživanja među liječnicima iz 2010. godine, došlo je do određenog povećanja razine svijesti o EBM-u. Međutim, za daljnje povećanje kvalitete EBM prakse u Hrvatskoj potrebni su bolji pristup izvorima EBM i daljnje obrazovne aktivnosti Hrvatskog Cochranea.Objective: Few studies were explored the role of evidence-based medicine (EBM) in the health system of the Republic of Croatia. This doctoral dissertation included two studies. The first study was a cross-sectional study on information, attitudes, knowledge and use of information on evidence-based medicine among patients in Croatia. The second study was a cross-sectional survey on the level of information, attitudes, knowledge, use of information and barriers to the application of EBM among family physicians, with or without specialization. Study design: In the first study, 978 patients from 10 family medicine practices from 5 Croatian regions (one practice from urban and one from rural areas) participated. The survey was conducted from September 2014 to September 2015, and a specially prepared questionnaire with 27 questions was used. Patients were asked about their activity in searching for additional information about their therapy and/or diagnosis, about using various sources of medical information, their knowledge of EBM, systematic reviews, about the Cochrane Library, about Cochrane Croatia and whether they read Cochrane plain language summaries prepared in Croatian language. Their sociodemographic data were also collected, including professional status, education level, gender and age. Croatian family physicians participated in the second cross-sectional study. Respondents were involved in two ways: during the continuing medical education courses for family physicians by filling out a printed version of the questionnaire, or they participated in the survey electronically, by using an online version of the questionnaire. The survey was conducted from April to September 2016. The study used a standardized questionnaire on EBM, which was expanded with socio-demographic questions and questions about the work of physicians that are adapted to the Croatian health system. Each respondent independently assessed the level of knowledge and understanding of EBM concepts. Results: Regarding the first study, half of the patients searched for the medical information from sources other than physician. Internet was the most common place they searched for 92 information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician’s opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs. rural residence were the predictors of awareness about EBM and systematic reviews (P < 0.001 for both). In the second study, 295 (14%) of all officially registered family physicians responded to the questionnaire. Respondents were very positive toward the promotion and usage of EBM. 160 (67%) indicated that they did not have access to the Cochrane Library. The majority reported lack of time available for finding evidence (80%), and patients’ unrealistic expectations that influence physicians’ choice of treatment (72%). Between the two groups of physicians, family medicine specialists more frequently reported time as barrier for finding evidence. The highest level of EBM terminology understanding was reported for study design terms, and the lowest for statistical terms. Conclusion: Our findings from the first study showed that patients consider a physician’s opinion to be the most reliable source of health related information which should be used for promotion of high quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary. The second study demonstrated that family physicians in Croatia had very positive attitudes toward the use of EBM, they agreed that EBM improves patient care, and they estimated that more than two thirds of their practice is EBM-based. Compared to the results of the previous survey of physicians in Croatia in 2010, there was some increase in the level of EBM awareness among family physicians. However, to further increase the quality of EBM practice in Croatia better access to EBM sources and further educational activities of Cochrane Croatia are needed

Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study.

Aim was to determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information ; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both). Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary

Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study.

Aim was to determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information ; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both). Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary

Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study

Aim was to determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information ; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both). Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary