Scope and Objectives: In response to the World Health Organization’s recommendation, policy makers have been adopting evidence-based healthcare approach to promote the development of traditional, complementary and integrative medicine (TCIM) into Hong Kong’s health system. Disseminating synopses of clinical evidence from systematic reviews or randomized trials is regarded as a potentially effective strategy to promote evidence uptake. The study aimed to identify barriers and facilitators to implementing this strategy among Hong Kong Chinese medicine practitioners (CMPs). Methods: Twenty-five CMPs aged under 45years and trained in Hong Kong after reunification with China in 1997 were interviewed individually. Four clinical evidence synopses of randomized trials and systematic reviews on Chinese medicine interventions were presented, and CMPs were asked to comment on their applicability in routine practice (Figure). The Consolidated Framework for Implementation Research (CFIR) was applied to guide interview and analysis. Keys: CFIR, The Consolidated Framework for Implementation Research; CMP(s), Chinese medicine practitioners. Results: The barriers included: i) CMPs’ perceived difficulties in applying complex evidence in decision-making and ii) inadequate training and limited consultation time. The facilitators were i) availability of publicly accessible and user-friendly synopses, ii) formation of community of evidence-based practice among CMPs with input from key opinion leaders, iii) opportunity for interprofessional collaborations with conventional healthcare providers, and iv) patients’ demand for evidence-based clinical advice. Besides, i) CMPs’ knowledge and beliefs in evidence-based healthcare approach, ii) presentations of evidence-based information in the synopses, and iii) clinical decision making as influenced by quality of evidence reported acted as both barriers and facilitators (Table). Conclusions: This CFIR-based qualitative study investigated how the World Health Organization recommendation of promoting evidence use in routine practice was perceived by CMPs trained in Hong Kong after reunification with China in 1997. Key barriers and facilitators to applying evidence were identified. Such results will inform tailoring of implementation strategies for promoting evidence uptake, in the context of a well-developed health system dominated by conventional medicine.
Dr. Irene Wu has completed Bachelor in Preventive Medicine, Master in Epidemiology and Health Statistics, and a PhD in clinical epidemiology and evidence-based medicine. She received her post-doctoral training in the Chinese University of Hong Kong, focusing on developing methods for evaluating traditional, complementary and integrative medicine in an evidence-based manner. Dr. Wu received the prestigious award of “High-level Talents Introduction Plan” from Central South University in 2018, and is currently a Professor in the Xiangya School of Public Health, Central South University. As a well-trained epidemiologist and biostatistician with focus on evidence-based healthcare, Dr Wu has a good research track record in in evidence based integrative medicine, of which she has published over 60 articles in international peer reviewed journals, including the BMJ, Journal of Clinical Epidemiology, and Obesity Reviews, among others. Dr Wu has received several competitive grants supports from the National Natural Science Foundation of China and National Key R&D Program of China.
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