Keywords: Evidence-Based Practice; Primary Care Physicians; Physicians, Family

Background:

Evidence-based practice (EBP) is a key component of high-quality primary care. However, the integration of research findings and clinical guidelines into everyday medical practice can be challenging, especially in settings with limited resources. Identifying the specific barriers faced by clinicians is crucial to designing strategies that can promote and facilitate EBP adoption.

Research questions:

What are the perceived barriers to implementing evidence-based practice among family physicians working in primary care settings in Türkiye?

Method:

A descriptive cross-sectional study was conducted between March and December 2024 using an online survey targeting family physicians across Türkiye. The questionnaire included three sections: (1) sociodemographic and professional characteristics; (2) a 13-item list of potential barriers to EBP, rated on a 3-point Likert scale (not affecting, partially, strongly affecting); and (3) the 15-item Evidence-Based Practice Attitude Scale (EBPAS), with items rated from 0 to 4.

Results:

A total of 245 family physicians participated. The most commonly reported barriers were limited access to full-text articles (59.6%), lack of time to read current literature (40.8%), and lack of reimbursement for guideline-based care (37.1%). The mean total EBPAS score was 35.0 ± 7.4, indicating moderately positive attitudes. Subscale scores were highest in Divergence (12.0), followed by Appeal (10.4), Openness (8.3), and Requirements (4.4). EBPAS scores showed no significant differences by gender, region, title, or patient load. However, age correlated negatively with total score (ρ = –0.24, p < 0.001). Physicians who “always” used guidelines had the highest average score (43.0). Open-ended responses frequently mentioned use of TEMD (Turkish Endocrinology Association) guidelines and National Public Health protocols on vaccination and maternal-child care.

Conclusions:

While attitudes toward EBP are generally positive, structural and practical barriers persist. System-level interventions are needed to improve access to evidence, encourage guideline use, and support younger clinicians in maintaining evidence-informed care.

Points for discussion:

How Can Access Barriers Be Overcome?

How Can Younger Physicians’ Positive Attitudes Be Sustained?

How Can Guideline Use Be Promoted in Daily Practice?