Internet use for information seeking in clinical practice: A cross-sectional survey among French general practitioners

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Abstract

Background

Medical information needs regarding patient care are particularly large for general practitioners (GPs). The Internet seems to be a relevant but underused tool to seek medical information.

Objective

We aimed to describe the characteristics of the French GPs using the Internet for information seeking, to identify the barriers to its use and the factors that could facilitate it.

Method

We conducted a cross-sectional survey among GPs currently practicing in France, using an online questionnaire, in July 2009. We analysed the answers of 721 respondents.

Results

Most of the respondents used the Internet to seek information. They were significantly younger, worked in group practice, had Internet training and had Internet access at the practice. The main barriers were related to the physician (lack of knowledge or specific skills), to the practice conditions (lack of time, concerns about relationship with patient, financial non-recognition) and to the information (information overload, quality concerns, low relevance, language barrier). Practitioners wanted more reliable and more relevant documents for daily practice. Websites with already selected resources could increase the GPs use of the Internet for medical information seeking.

Conclusion

The reported obstacles were largely common with those previously described in other countries, except the language barrier and the financial non-recognition. Even if the generalization of our results to all French GPs should be cautious, the study provided better insights into the obstacles to the Internet use to seek clinical information in family practice and the factors that could facilitate it.

Highlights

► Internet use has not replaced the “traditional” sources of medical information. ► French GP users were significantly younger and worked in group practice. ► Language barrier and financial non-recognition were obstacles.

Introduction

Physicians are not “all-knowing”. Biomedical knowledge doubles about every 20 years [1]. To practice a high quality medicine, physicians have to constantly update their knowledge and find the information they need to integrate the best evidence in their clinical decisions [2]. The average number of clinical questions facing the general practitioner (GP) is between 0.07 and 1.85 per consultation [3]. In the broad scope of family practice, problems encountered and questions arising are particularly wide-ranging. Clinical information needs are larger for GPs than for colleagues in other specialties [4].

The Web has the characteristics of an ideal source of medical knowledge [5] and the Internet seems to be a relevant tool for information regarding patient care. It is hoped it could help doctors by providing them with the helpful information as they see a patient [6], [7]. Physicians can use the Internet to solve clinical problems, to support decision-making and to overcome memory limits [8]. The use of online retrieval information systems can help physicians to better answer their clinical questions [9]. Despite an increasing access to Internet, GPs still seem to prefer printed resources, Continuing Medical Education (CME) or contact with their colleagues to answer the questions arising in their clinical practice [3], [10], [11]. GPs usually believe information in medical journals to be more reliable than information published on the Web [12].

Time constraints are commonly reported in literature. GPs only seek answers to between 30% and 57% of their clinical questions [3] and they spend, on average, less than 2 min seeking answers [13]. Many obstacles are related to information seeking [14]. The skills to perform a literature search are often limited or lacking and most of the GPs are unfamiliar with using online tools. Information overload is a barrier to using the Internet in daily practice [4]. Web-based information is heterogeneous in quality, and not always fit to a direct use for practice [15]. Age, gender, and practice type or location can impact Internet use, but are not always taken into account in literature. Immediacy of access to information is an important and helpful aspect [16]. Computer availability when consulting was a predictive factor to Internet access at work [17]. Training needs are frequently reported in literature [18] and could facilitate the practitioners’ use of the Internet. Learning about how to use the Internet and experiencing its benefits could increase its use by GPs [19]. Websites or portals with relevant information or selected links could guide clinicians in the Web-based resources [12].

The aims of our study were to describe the characteristics of the French GPs using the Internet for clinical information search to identify the barriers to this Internet use and the factors that could facilitate it.

Section snippets

Method

We conducted a cross-sectional survey among French GPs, using an online self-administered questionnaire. The study protocol was approved by the Ethics Committee of the French Society of General Medicine.

Results

During the survey period, the URL for accessing the questionnaire was opened 1 112 times and 874 GPs validated at least the first screen of the questionnaire. We analysed results from a total of 721 GPs who did validate the three screens (to limit missing data). Because of the survey method, we could neither calculate the response rate nor the number of the non-included physicians.

Principal findings

Most of the French surveyed GPs currently use the Internet to seek medical information regarding patient care, without replacing the “traditional” resources (printed journals and CME). In comparison with non-users, users were significantly younger, worked in group practice, had Internet training and Internet access in their consultation room.

The main barriers identified could be related to the physician (lack of knowledge or specific skills), to the practice conditions (lack of time, concerns

Conclusions

Most of surveyed GPs used the Internet to seek information regarding patient care. Their reported obstacles were largely common with those previously found in other countries, except the language barrier and non-recognition. More relevant information and selected resources could facilitate this Internet use for daily practice. A convenience sample and declarative answers are the main limits of our study. Even if our results can not be generalized without caution to all French GPs, the study

Conflict of interest

All authors declare that they have no conflicts of interest in relation to this manuscript.

Author contributions

Study concept and design: EB, MA. Analysis and interpretation of data, including statistical analysis: EB, MA, DD, GH. All authors contributed to the final version of the manuscript.

Acknowledgments

The study was funded by the Professional Association of Independent Physicians (URML) of Île-de-France (Paris, France). The URML had no involvement in the study design, in the collection, analysis and interpretation of data; in the writing manuscript; in the decision to submit the manuscript for publication. The authors would like to thank all the general practitioners who participated in the study. We also want to thank Dr. Edith Halvorson and Ms. Aurélie Deveille for English correction.

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