Qualitative research and the take-up of evidence-based practice

Britten, Nicky

Professor of Applied Health Care Research, Peninsula Medical School, University of Exeter
Nicky Britten (MA, MSc, PhD, FRCGP (Hon), FRSA), Professor of Applied Health Care Research at the Peninsula Medical School, University of Exeter, UK, is a sociologist with particular interests in the sociology of prescribing and use of medicines, patient-doctor communication, patient and public involvement in research, and the synthesis of qualitative research. She is author of ‘Medicines and Society: Patients, Professionals and the Dominance of Pharmaceuticals’ (Palgrave Macmillan, 2008) and co-editor of the ‘Oxford Textbook of Primary Medical Care’ (ed R Jones et al., Oxford University Press, 2003) and of ‘Patient Participation in Health Care Consultations: Qualitative Perspectives’ (ed S Collins et al., 2007, Open University Press). She is a member of the Executive Committee of the National Institute for Health Research Collaboration for Leadership in Applied Health Care and Research for the South West Peninsula (PenCLAHRC).

Corresponding author: Nicky Britten, Professor of Applied Health Care Research, Peninsula Medical School, University of Exeter, UK

E-mail: [email protected]

Journal of Research in Nursing 15(6):p 537-544, November 2010. | DOI: 10.1177/1744987110380611

Abstract

In this paper it is argued that evidence-based medicine (EBM) is a social movement as well as a scientific enterprise, and that as such it requires qualitative investigation of its various activities to understand its impact and take-up. Randomised controlled trials (RCTs) are a blunt instrument of assessing whether interventions achieve intended or unintended outcomes, or whether they are acceptable to those they are aimed at. To understand the success or failure of evidence-based interventions, it is necessary to investigate practitioners' acceptance of, or resistance to, EBM. This involves exploration of the perceived relationships between practical clinical knowledge derived from everyday practice and scientific knowledge. The implementation of best evidence also requires the acknowledgement of local contextual factors. The goals of EBM will not be achieved if patients do not accept the advice and prescriptions they are given by professionals. One of the reasons that some professionals find it difficult to use the results of RCTs in their clinical practice is because they are aware of patients' differing priorities and life experiences. If we accept that EBM is a social movement, then the methods needed to investigate its activities are those of the social sciences, including qualitative methods.