Clinical information needs of the allopathic medical practitioners in developing country, India: a descriptive analysis with workplace.

Author:Bomman, Sathivel Murugan
Position:Report
 
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Introduction

Medical Information is playing a vital in the allopathic medical practice. Technological advances have made medical information a new basic resource like matter and energy. It provides knowledge and intelligence to the users. Therefore, information is necessary and the information generated at any point is procured, organized and disseminated expeditiously to its optimum use. Information must be made available at the right time without any barrier (Sathivel Murugan, 2000). A qualified medical practitioner, who is entrusted with the physical and mental well-being of his/her patients, must realize his/her obligations to his/her patients. They must also be aware of their responsibility to the development of the society (Apurba, 2005).

As an information-intensive specialty without patient limits of age, gender, or medical profession, family physicians require a number of different resources to cover the broad scope of practice. Critical skill for family physicians is the timely access to that wide variety of clinical information sources that contribute to the decisions in patient care. Specific questions about patient management arise in daily practice with drug prescribing-questions, being the most common type of questions (Ely et al, 1999).

The great strides of progress made in the modern medicine, diagnostic techniques, surgery and health care system have raised many problems in respect of standard of patient care, extent of human right protection and adequacy of systems and accountability. Physicians frequently rely on their personal knowledge accumulated over the years of clinical practice for patient care. They also need to update their professional knowledge periodically. They are expected to manage a wide range of medical problems for a broad patient population (Margaret, 1997).

Gorman, Yao & Seshadri (2004) undertook a study to determine if the information seeking behaviour of primary care medical staff in rural areas was different to that in non-rural areas. The results showed there were no differences in terms of the number of questions asked, the number of questions pursued and the number of questions answered. This reinforced the earlier work by Dorsch (2000) who reached a similar conclusion.

General practitioners (GPs) occupy a position of pivotal importance in the primary care led National Health Service (NHS). The effective management of the patient experience and input to organizational structures and quality assurance processes are critical. Hence, knowledge services for primary care staff must be found on a close understanding of all the target user groups. It is vital that information provision meets the priorities and preferences of General Practitioners (Sathivelmurugan & Allysornam, 2011). There are two main reasons for clinical Information needs of the physicians, viz., 1) to find or obtain answer to patients' specific questions that cannot be answered through their personal knowledge alone, and 2) to keep abreast of the developments in clinical practice (Karen, 2008). Clinical Information Need - The need for information by doctors in the patient care setting as a tool to manage the patient's care. This is a different process from information use in an academic setting for teaching, research and publication. In the medical field, clinical information needs are principally generated by treating patients (Smith, 1996).

Majority of the medical practitioners (83-100%) want updates on information pertaining to drugs and medical products/equipments clinical practice require more information on drugs (100%), new medical products/equipments (73-76%) drug information (60-100%) (Shafi & Mudassir, 2011)

Patient care, keeping up-to-date, research, writing for publication, teaching, patient education,(Tsafrir & Grinberg, 1998), Drug Information for 2nd and 3rd Cancer (Strasser, 1978), Disease related 49%, Drug related 23%, treatment procedure related 19%, (Northup et al, 1983), Treatment 31%, Diagnosis 25%, Drug related 14%, General medicine 48%, Dermatology 11% (Covell et al, 1985), Drug related 38%, Laboratory tests 25% (Williamson et al, 1989) Treatment 77%, Differential diagnosis 75%, Drug related 64%, Diagnosis 55%, Treatment 33%, Orthopaedics 29%, Internal medicine 26% (Woolf et al, l989) Specific patient 61%, Treatment 25% (Osheroff et al, 1991), Treatment 73%, Drug related 49%, Diagnosis 27% (Ely et al 1992), Treatment 34%, Diagnosis 28%, Drug related 18%, (Bowden et al, 1994), Treatment 24%, Drug related 18% (Guise et al, 1994) are the needed information for the medical practitioners.

Medical practitioner's clinical information need is analysed with gender, educational qualification and workplace was done by Sathivelmurugan, Allysornam, & Mohankumar. These results are as follows, gender of the medical practitioners and differential diagnosis, drug adverse effects and preparation of guest lecture/CME information needs have 5% level of statistical significant difference and diagnostic-procedures, disease-description, diseaseprognosis, and treatment-efficacy have 1% level of significant difference. There is a significant difference between the educational qualification of the practitioners and the following information needs, clinical-epidemiology, diagnosis/etiology, disease-description, emergencyprotocol, higher-education, preparation of guest lecture/CME and treatment efficacy. The following information needs, clinical-epidemiology, etiology, differential-diagnosis, diseasecomplications, disease-descriptions, disease-prognosis, drugs adverse effects, diagnostic-procedures, emergency-protocol, higher-education, patient-education, preparation of guest lecture/CME, research and publication, treatment including drug-therapy, treatment-efficacy have significant difference (either @ 1% or @ 5% level) between the workplace.

The age of the physician is one of the characteristic that influences preferences for information sources. Younger physicians appear to make greater use of medical literature and of colleagues than did their older counterparts. In contrast, older physicians more often used pharmaceutical representatives and preferred CME courses for seeking the medical information (Stinson, 1980), (Lockyer, 1985) and these differences may not be attributable simply to differences in level of experience. Gruppen and colleagues found that the level of experience, either in general or with a particular problem, did not influence the physicians' preferences for different information sources (Gruppen, 1988)

Objectives of this study

This study was set out to understand the clinical information needs of the allopathic medical practitioners' in Tamilnadu. It is analysed with experience. The main objectives of the present study is as follows,

  1. To find out the level of clinical information needs of the medical practitioners 2. To correlate the clinical information needs with Gender, educational qualification and workplace of the practitioners. Methodology

    This study adopts a descriptive survey type of research design. The study population is selected from the following districts Salem, Erode, Tirppur, Coimbatore and the Niligris in Tamilnadu, India. Indian Medical Council, New Delhi recognized qualified medical practitioners are involved this study. Educational qualification of the study sample is MBBS, MBBS with Diploma in various disciplines and MD/MS/DNB. Doctors are doing their practice in government side, private practice and both. Government Doctors lists are collected from the Joint Director of Health...

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