Information-Seeking behaviour and Attitudes of Physicians Toward Drug Information Resources and Services in Saudi Arabia: a nationwide Survey Hisham S. Abou-Auda, Ph. D



Download 2.61 Mb.
Page2/3
Date15.12.2016
Size2.61 Mb.
1   2   3

DISCUSSION

This is the first ever survey to be conducted in KSA to measure the attitudes of physicians towards DICs. To date, no attempts have been made to investigate this issue or the physicians’ information-seeking behaviour in this part of the world. There is only little earlier research into drug information services in KSA (7-9) and Kuwait (12). All these studies were a description of activity statistics of the DICs. Other studies focused on the prescribing behaviour of primary care physicians in KSA (13-16).

In the present work, information resources currently utilized by physicians were assessed. Physicians were also surveyed concerning their information-seeking behaviour and their awareness and satisfaction with the services provided to them by DICs. They were also questioned regarding their expectations and future information needs. We tried to obtain representative sample of physicians and dentists and to obtain a good response rate to assure the validity of the study. All respondents were seeing patients regularly in their sites of practice at the time of the study. Our response rate (65.9%) was favorable and consistent with other surveys of attitudes of health professionals conducted elsewhere. Whilst this response rate cannot be representative of all physicians and dentists in KSA, all regions of the country were represented in this survey, so it is fair to say that the survey provides a sound foundation for at least some tentative conclusions about the questions raised by the study.

The information-seeking behaviours of physicians and dentists in KSA were not very different from those in the UK and USA. The results of our study revealed that textbooks, periodicals, symposia/CME and company representatives (detailmen) were the most frequently consulted sources of information about drugs. The overwhelming dependence of physicians and dentists on textbooks to answer drug related questions was almost predictable. Lack of unbiased and reliable information on drugs contributes to the inappropriate prescribing among primary care physicians (13-16). In most developing countries such as KSA, one of the major sources of information available to physicians appears to be drug company salesmen. Western physicians (USA, UK, Germany) were less likely to rely on books compared to Arab physicians. In western countries, primary care physicians use their colleagues to help them evaluate and validate the medical development about which they read. They also rely on peers who they feel are better informed about medical advances; therefore, they seek their advice and opinion regarding a multitude of issues including diagnosis and drug treatment (17,18). Our results indicated that Western physicians working in KSA were less likely to use their colleagues as information source which probably reflects a confidence crisis due to the difference between both groups in their basic medical training. This relatively high utilization of textbooks for information about new drugs reflects a lack of confidence in other information sources or reluctance from the side of the physicians to admit to being informed by others. The use of textbooks and journal articles may provide adequate information necessary to make prescribing decisions, but to be used effectively as a major information source, a large medical library or information center would be required, which is beyond the physicians’ limited resources. Ely et al. (19) recorded the titles of all medical books in the personal libraries of 103 randomly selected family physicians; they found that drug-prescribing textbooks were the most common type of books in the physicians’ offices, followed by books on general internal medicine and adult infectious diseases. Furthermore, Connelly et al. (20) reported that physicians used the Physicians’ Desk reference (PDR) on daily basis, consulted colleagues at least weekly, but rarely used electronic information-retrieval systems. This result, with the exception of the use of colleagues, is in agreement with our results since most of the surveyed physicians in our sample were affiliated with primary care institutions. The striking observation from this study was that pharmacists and colleagues were the least consulted sources.

Our sample of physicians comprised approximately 30% of physicians who are practicing in rural areas of KSA. Gorman (21) compared the self-reported information needs of rural and rural primary care physicians and found that rural physicians reported less frequent use of consultants, colleagues, librarians, and bound journals, a result in a close agreement with our findings. Generally, all results are supporting the idea of establishing specialized DICs, not only in major cities, but also in rural areas. As in the present work, where physicians were satisfied with the drug information services provided to them, other investigators concluded similar observations. In a study (22) dealing with the quality and impact of problem-oriented drug information, 79% of the surveyed physicians found that the answers provided to them by the DIC were fast enough, relevant, adequately comprehensive and with valuable references. Furthermore, the majority of these physicians thought that the answers had caused a change in their clinical practice.

Although it was not one of the aims of this study to determine the use of electronic and computerized information-retrieval systems, the use of the Internet was investigated. Our results suggested low levels of awareness and expertise in such resources especially among private sector physicians. One of the probable reasons for the low use of the Internet was the unavailability of this service for physicians in their private institution due to cost considerations. In addition, it may be worth mentioning that our results revealed that the use of electronic resources increased with recency of training. This result may be due to the fact that some medical schools in KSA just started to introduce courses of medical informatics in their curricula. Other studies also reported a relatively poor access to computers among physicians (23-25). This result does not promote using the Internet as a substitute for DICs. The quality and reliability of drug information on the Internet is still questionable. Seaboldt and Kuiper (26) compared responses to drug information questions posted on the Internet Usenet pharmacy newsgroup (sci.med.pharmacy) with responses from DICs. They found a significantly smaller proportion of accurate drug information responses from the Usenet newsgroup compared with responses from DICs.

On the other hand, the awareness of the existence of DICs was investigated. Approximately one third of the physicians were not aware of the existence of these centers in KSA. The majority of those physicians were affiliated with the private sector. This is probably due to the fact that no private sector health institution in KSA has a DIC, where all centers are governmental property. From economical point of view, DICs are not considered profit-generating projects since there are no fees-for-service in KSA as the case of some developed countries. But the striking observation is that about half of the physicians who were aware of the service had never used it, probably reflecting the low trust level in pharmacist-operated DICs, a result consistent with the low use rate of pharmacist as a drug information resource.

Similarly, although physicians attempted to find information, on their own, in excess of 17 times during the last 6 months prior to the survey, and despite the relatively high satisfaction rating with the services provided to them by these centers, they only requested information on only two occasions during the last 6 months prior to the survey. This is probably due to the ignorance of what is available at these centers or probably because they live in an information-rich environment. A contradicting observation was that physicians who had previously used these centers to request information directly and indirectly expressed their satisfaction with services provided to them. Despite their low usage figures, they almost unanimously (98.7%) stated that they would encourage their colleagues to use these centers. The majority of physicians rely heavily on their personal knowledge, accumulated over years of practice and built up through their past medical education. Our results proved that the future information needs of dentists from DICs are relatively different from the information needs of GPs and consultants. These results are in agreement with other findings (27-29). Generally, information relating to complementary/herbal medicine; cautions/contraindications/adverse effects of drugs and drug overview (drug monographs) represented the major drug information categories might be requested from DICs in the future.


CONCLUSIONS

The results clearly highlighted the relatively passive attitude of physicians towards drug and poison information centers in KSA. These centers are underutilized by health care professional, in part due to the lack of awareness of their existence by physicians. Physicians always deal with an ever-expanding and often overwhelming information universe, including not only reliable primary sources, but also computerized secondary sources and well-established databases. Thus, considering the cost and time of pursuing new information about drugs, and accounting for the shortcomings of medical literature, physicians should use the expertise of drug information specialists to help them in obtaining reliable, validated and well-documented information. On the other hand, DICs have to evaluate their own current processes and outcomes, to set goals and to improve the quality of their services. They also have to reach to physicians through active approaches such as drug newsletters and continuing education programs in information-retrieval and evaluation techniques to promote and publicize their existence, and declare the opportunities available to physicians in terms of the ability of these centers to satisfy their information needs.



REFERENCES

  1. Abou-Auda HS. (2003) An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries. Clinical Therapeutics, 25, 1276-1292




  1. Ruppelt SC, Vann AR. (2001) Marketing a hospital-based drug information center (letter). American Journal of Health-System Pharmacists, 58, 1040




  1. Mullerova H, Vlacek J. (1997) Drug information centre-analysis of activities of a regional centre. International Journal of Medical Information, 45, 53-58




  1. Scala D, Bracco A, Cozzolino S, Cristinziano A, De Morino C, Di Martino A, Gonzalez E, Mancini A, Romagnuolo F, Zeuli L. (2001) Italian drug information centres: benchmark report. Pharmacy World & Science, 23, 217-223




  1. Wharrad H, Robinson J. (1999) The global distribution of physicians and nurses. Journal of Advanced Nursing, 30, 109-120




  1. Robinson JJA, Wharrad H. (2001) The relationship between attendance at birth and maternal mortality rates: an exploration of United Nations' data sets including the ratios of physicians and nurses to population, GNP per capita and female literacy. Journal of Advanced Nursing, 34, 445-455




  1. Timm DM, Swartz KM, Amoh KN. (1991) King Khalid University Hospital Drug and Poison Information Service. A descriptive report and comparison with the University of Minnesota Drug Information Center. Journal of Pharmaceutical Technology, 7, 179-183




  1. Najjar TA, Al-Arifi MN, Gubara OA, Dana MH. (2000) Ethical requests by drug and poison information center in Saudi Arabia. Journal of Social and Administrative Pharmacy, 17, 234-237




  1. Al-Arifi MN, Gubara OA, Korashy HM. (1997) Drug information centers in Saudi Arabia: evaluation of community pharmacists’ services in Riyadh city. Saudi Pharmaceutical Journal 5, 183-189




  1. Cronbach LJ. (1951) Coefficient alpha and the internal structure of test. Psychometrika, 16, 297–334




  1. Babbie B. (2001) The practice of social research. 9th ed. Stamford, CT: Wadsworth.




  1. Tarifi HA, Assad AM, Ani FM. (1990) Drug information centers as bases for continuing education programs in Kuwait. Drug Intelligence and Clinical Pharmacy, 24, 769-771




  1. Al-Doghether MH, Al-Megbil TI. (2004) Prescribing in primary care for the older people. Saudi Medical Journal25,   488-492




  1. Mahfouz AA, Shehata AI, Mandil AM, Al-Erian RA, Al-Khuzayem AA, Kisha A. (1997) Prescribing patterns at primary health care level in the Asir region, Saudi Arabia: an epidemiologic study. Pharmacoepidemiology & Drug Safety, 6, 197-201




  1. Al-Nasser AN. (1991) Prescribing patterns in primary healthcare in Saudi Arabia. Drug Intelligence and Clinical Pharmacy, 25, 90-93




  1. Irshaid YM, Al-Homrany MA, Hamdi AA, Adjepon-Yamoah KK, Mahfouz AA. (2004) A pharmacoepidemiological study of prescription pattern in outpatient clinics in Southwestern Saudi Arabia. Saudi Medical Journal, 25, 1864-1870




  1. Weinberg AD, Ullian L, Richards WD, Cooper. (1981) Informed advice- and information-seeking between physicians. Journal of Medical Education, 56, 174-180




  1. Smith GH, Sorby DL, Sharp LJ. (1975) Physician attitudes toward drug information resources. American Journal of Hospital Pharmacy, 32, 19-25




  1. Ely JW, Levy BT, Hartz A. (1999) What clinical information resources are available in family physicians' offices? Family Practice, 48, 135-139




  1. Connelly DP, Rich EC, Curley SP, Kelly JT. (1990) Knowledge resources preference of family physicians. Journal of Family Practice, 30, 353-359




  1. Gorman P. (2001) Information needs in primary care: a survey of rural and nonrural primary care physicians. Medinfo, 10, 338-342  




  1. Schjott J, Pomp E, Gedde-Dahl A. (2002) Quality and impact of problem-oriented drug information: a method to change clinical practice among physicians? European Journal of Clinical Pharmacology, 57, 897-902




  1. Nicolas D, Williams P, Smith A, Longbottom P. (2005) The information needs of perioperative staff: a preparatory study for a proposed specialist library for theatres (NeLH). Health Information & Libraries Journal, 22, 35–43




  1. Rutter J, Brown D, Rutter P. (2004) Primary care practitioners’ uptake of a secondary care-based medicines information service in the United Kingdom. Drug Information Journal, 38, 407-416




  1. Andrews JE, Pearce KA, Ireson C, Love MM. (2005) Information-seeking behaviors of practitioners in a primary care practice-based research network (PBRN). Journal of Medical Libraries Association, 93, 206-212




  1. Seaboldt JA, Kuiper R. (1997) Comparison of information obtained from a Usenet newsgroup and from drug information centers. American Journal of Health-System Pharmacists 54, 1732-1735




  1. Morrow NC, D’Arcy PF, Pielou LW. (1984) Drug information inquiries—who asks what and where are the answers. Journal of Clinical and Hospital Pharmacy, 9, 321-331




  1. Hayman JN, Brown TR, Smith MC, Liao W. (1978) Physician use and evaluation of a hospital-based drug information center. American Journal of Hospital Pharmacy, 35, 1238-1240




  1. Rosenberg JM, Koumis T, Nathan JP, Cicero LA, McGuire H. (2004) Current status of pharmacist-operated drug information centers in the United States. American Journal of Health-System Pharmacists, 61, 2023-2032







GP

n (%)


Consultant

n (%)


Dentist

n (%)


p-value

Age Group (years) (n=1229)













≤ 39

299 (80.6)

346 (53.4)

81 (73.0)

<0.001

40–49

53 (14.3)

251 (38.7)

26 (23.4)




≥ 50

19 (5.1)

51 (7.9)

4 (3.6)




Gender













Male

267 (64.3)

550 (79.3)

73 (60.8)

<0.001

Female

148 (35.7)

144 (20.7)

47 (39.2)




Workplace (n=1229)













Specialist Hospital

30 (7.2)

85 (12.2)

6 (5.0)

<0.001

Primary care Hospital

232 (55.9)

385 (55.5)

55 (45.8)




Clinic/Health Center

140 (33.8)

204 (29.4)

43 (35.8)




Solo Practice

5 (1.2)

8 (1.2)

5 (4.2)




Others (e.g., infirmaries)

8 (1.9)

12 (1.7)

11 (9.2)




Total years of experience (n=1224)













≤ 10

306 (73.9)

230 (33.2)

58 (48.7)

<0.001

11–19

74 (17.9)

318 (45.9)

36 (30.3)




≥ 20

34 (8.2)

145 (20.9)

25 (21.0)




Employment in current workplace (years) (n=1184)













≤ 10

370 (92.1)

550 (81.6)

90 (85.1)

<0.001

11–19

25 (6.2)

95 (14.1)

19 (17.1)




≥ 20

7 (1.7)

29 (4.3)

2 (1.8)


















Table 1. Demographic characteristics of the physicians and dentists

Table 2. Specialty of the physicians



Specialty

n (%)

Internal Medicine

195 (17.9)

Pediatrics

191 (17.5)

Obstetrics/Gynaecology

121 (11.1)

Family Practice

97 (8.9)

Surgery

96 (8.8)

E.N.T

60 (5.5)

Dermatology

53 (4.9)

Ophthalmology

43 (3.9)

Urology

28 (2.6)

Orthopedics

27 (2.5)

Neurology

13 (1.2)

Psychiatry

12 (1.1)

Osteopathic Physician

9 (0.8)

Others

144 (13.2)





Share with your friends:
1   2   3


The database is protected by copyright ©dentisty.org 2019
send message

    Main page