Evidence-Based Care Gaps Pervasive, Researchers Say

Healthcare systems around the world are failing to use evidence obtained through research, according to Sharon E. Straus, MD, MSc, FRCPC, a geriatrician and director of knowledge translation at St. Michael's Hospital in Toronto. The result: reduced length and quality of life, she and her colleagues write in a recent paper.

Straus was the guest editor of the January issue of the Journal of Clinical Epidemiology, which featured articles on knowledge translation. Knowledge translation is the term for closing the gap between evidence and data obtained through research and healthcare practice and policy.

More simply, it addresses the gap between what we know and what we do.

Failure to use research-based evidence to inform healthcare decision making are is prevalent among patients, caregivers, managers, and policymakers across all disciplines and in developed anddeveloping countries, she and her colleagues note in one of the articles.

Extrapolating data from the United States, they estimate that about 55 percent of adult patients do not receive recommended care. Studies have shown that only 40 percent of people with osteoporosis get appropriate therapy, Straus points out.

Moreover, only two-thirds of stroke patients receive appropriate, evidence-based care. She offers the following example: Although research indicates that statins can decrease the risk of death after strokes, they are “considerably under-prescribed.”

Overprescribing is also a problem. For instance, antibiotics continue to be prescribed for children with upper respiratory tract infections despite evidence they are ineffective.

She tells HealthLeaders Media that more than 250 barriers to implementation of guidelines by physicians have been identified. They can include cost, education, scarce healthcare resources and the sheer volume of research evidence being produced.