Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions.
BACKGROUND
Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent.


OBJECTIVE
Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation.


METHODS
Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies.


METHODS
Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included.


METHODS
One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions.


RESULTS
Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP.


CONCLUSIONS
Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias.


CONCLUSIONS
There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP.
Psychological Sciences, Institute of Health and Society, University of Worcester, Henwick Grove, Worcester WR2 6AJ, UK. Electronic address: l.scurlock-evans@worc.ac.uk.
Laura
L
Scurlock-Evans
Institute of Health and Society, University of Worcester, Henwick Grove, Worcester WR2 6AJ, UK.
Penney
P
Upton
Faculty of Health, University of Canberra, University Dr, Bruce ACT 2617, Australia.
Dominic
D
Upton
D055317:Evidence-Based Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D026741:Physical Therapy Modalities; D011785:Quality Assurance, Health Care
Best Practices; Decision Making; Evidence-Based Practice; Physiotherapists; Practice-Research Gap; Review