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BMC Health Services Research

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Open Access 01-12-2024 | Public Health | Research

Challenges of using evidence in managerial decision-making of the primary health care system

Authors: Marjan Hedayatipour, Sina Etemadi, Somayeh Noori Hekmat, Alisadat Moosavi

Published in: BMC Health Services Research | Issue 1/2024

Abstract

Background

Managerial Evidence-Based Decision-Making [EBDM] in the primary is a systematic approach that directs the decision-maker in a conscientious, explicit, and judicious utilization of reliable and best evidence based on the professional experiences and preferences of stakeholders and patients from various sources. This study aimed to investigate the challenges primary healthcare managers encounter while undertaking decision-making processes.

Method

A systematic review was conducted in 2022 with the aim of identifying and collecting all qualitative articles pertaining to evidence-based decision-making in the primary healthcare system. To achieve this, a meticulous search was conducted using the relevant keywords, including primary health care and evidence-based decision making, as well as their corresponding synonyms, across the databases Web of Science, Scopus, and Pubmed. Importantly, there were no limitations imposed on the timeframe for the search. To carefully analyze and consolidate the findings of this systematic review, the meta-synthesis approach was employed.

Results

A total of 22 articles were assessed in this systematic review study. The results revealed the main categories including evidence nature, EBDM barriers, utilizing evidence, decision-makers ability, organizational structure, evidence-based, EBDM support, communication for EBDM, evidence sides, EBDM skill development, public health promotion, and health system performance improvement.

Conclusion

The primary healthcare system is crucial in improving health outcomes and ensuring access to healthcare services for all individuals. This study explored the utilization of evidence-based EBDM within the primary healthcare system. We identified five key dimensions: causal, contextual, and intervening conditions, strategies, and consequences of EBDM as a core phenomenon. The findings will help policymakers and administrators comprehend the importance of evidence-based decision-making, ultimately leading to enhanced decision quality, community well-being, and efficiency within the healthcare system. EBDM entails considering the best reliable evidence, and incorporating community preferences while also exploiting the professional expertise and experiences of decision-makers. This systematic review has the potential to provide guidance for future reforms and enhance the quality of decision-making at the managerial level in primary healthcare.

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Sample, Phenomenon of Interest, Design, Evaluation, and Research Type.

Persaud DD, Murphy M. The ELIAS framework: a prescription for innovation and change. Healthc Manage Forum. 2020;34(1):56–61.PubMedCrossRef

Al-Habib NMI. Leadership and organizational performance: Is it essential in healthcare systems improvement? A review of literature. Saudi J Anaesth. 2020;14(1):69.PubMedPubMedCentralCrossRef

Bastani P, Alipoori S, Imani-Nasab M-H, Jamalabadi S, Kavosi Z. Evidence-based decision making among healthcare managers: evidence from a developing country. Int J Healthcare Manage. 2021;14(1):197–202.CrossRef

Guo R. Prediction of intention to use evidence-based management among healthcare administrators in the United States. School of Health Sciences, Central Michigan University, Mount Pleasant, Michigan; 2015.

Kurien VTV, Shamsuddeen S, Mahitha M, Rasheed DS. Evidence-based decision-making. J Head Neck Physicians Surg. 2022;10(1):48–52.

Saberi IM. Evidence-based management and its application in the hospital management process. Hosp Pract Res. 2018;3(2):35–6.CrossRef

Guo R, Berkshire SD, Fulton LV, Hermanson PM. Use of evidence-based management in healthcare administration decision-making. Leadersh Health Serv. 2017;30(3):330–42.CrossRef

Barends E, Villanueva J, Rousseau DM, Briner RB, Jepsen DM, Houghton E, et al. Managerial attitudes and perceived barriers regarding evidence-based practice: an international survey. PLoS One. 2017;12(10):e0184594.PubMedPubMedCentralCrossRef

Shafaghat T, Bastani P, Nasab MHI, Bahrami MA, Montazer MRA, Zarchi MKR, et al. A framework of evidence-based decision-making in health system management: a best-fit framework synthesis. Arch Public Health. 2022;80(1):1–20.CrossRef

10.

Janati A, Hasanpoor E, Hajebrahimi S, Sadeghi-Bazargani H. Evidence-based management–healthcare manager viewpoints. Int J Health Care Qual Assur. 2018;31(5):436–48.PubMedCrossRef

11.

Jacob RR, Duggan K, Allen P, Erwin PC, Aisaka K, Yang SC, et al. Preparing public health professionals to make evidence-based decisions: a comparison of training delivery methods in the United States. Front Public Health. 2018;6:257.PubMedPubMedCentralCrossRef

12.

Hasanpoor E, Hajebrahimi S, Janati A, Abedini Z, Haghgoshayie E. Barriers, facilitators, process and sources of evidence for evidence-based management among health care managers: a qualitative systematic review. Ethiop J Health Sci. 2018;28(5):665.PubMedPubMedCentral

13.

Rynes SL, Bartunek JM. Evidence-based management: Foundations, development, controversies and future. Annu Rev Organ Psych Organ Behav. 2017;4:235–61.CrossRef

14.

Hoffmann T, Bennett S, Del Mar C. Evidence-based practice across the health professions. 2nd ed. Australia: Elsevier; 2013.

15.

Pazhohesh JA. Evidence-based management: a bridge for the gap between the management science and manager practice. Roshd-e-Fanavari. 2017;3(51):52.

16.

Abelsson T, Morténius H, Karlsson A-K, Bergman S, Baigi A. Evidence-based practice in primary healthcare from the managerial point of view–a national survey. BMC Health Serv Res. 2021;21(1):1–10.CrossRef

17.

Banasiewicz AD. Evidence-based decision-making: how to leverage available data and avoid cognitive biases. New York: Routledge; 2019.

18.

Alavi SH, Marzban S, Gholami S, Najafi M, Rajaee R. How much is managers’ awareness of evidence based decision making? Biomed Pharmacol J. 2015;8(2):1015–23.CrossRef

19.

Connor L, Dean J, McNett M, Tydings DM, Shrout A, Gorsuch PF, et al. Evidence-based practice improves patient outcomes and healthcare system return on investment: findings from a scoping review. Worldviews Evid Based Nurs. 2023;20(1):6–15.PubMedCrossRef

20.

Janati A, Hasanpoor E, Hajebrahimi S, Sadeghi-Bazargani H, Khezri A. An evidence-based framework for evidence-based management in healthcare organizations: a delphi study. Ethiop J Health Sci. 2018;28(3):305–14.PubMedPubMedCentralCrossRef

21.

Majers JS, Warshawsky N. Evidence-based decision-making for nurse leaders. Nurse Lead. 2020;18(5):471–5.CrossRef

22.

Janati A, Hasanpoor E, Hajebrahimi S, Sadeghi-Bazargani H. Health care managers’ perspectives on the sources of evidence in evidence-based hospital management: a qualitative study in Iran. Ethiop J Health Sci. 2017;27(6):659–68.PubMedPubMedCentralCrossRef

23.

Mazzucca S, Parks RG, Tabak RG, Allen P, Dobbins M, Stamatakis KA, et al. Research full report: assessing organizational supports for evidence-based decision making in local public health departments in the United States: development and psychometric properties of a new measure. J Public Health Manag Pract. 2019;25(5):454.PubMedPubMedCentralCrossRef

24.

Allen P, Mazzucca S, Parks RG, Robinson M, Tabak RG, Brownson R. Local health department accreditation is associated with organizational supports for evidence-based decision making. Front Public Health. 2019;7:374.PubMedPubMedCentralCrossRef

25.

Dobbins M, Traynor RL, Workentine S, Yousefi-Nooraie R, Yost J. Impact of an organization-wide knowledge translation strategy to support evidence-informed public health decision making. BMC Public Health. 2018;18:1–15.CrossRef

26.

McVay AB, Stamatakis KA, Jacobs JA, Tabak RG, Brownson RC. The role of researchers in disseminating evidence to public health practice settings: a cross-sectional study. Health Res Policy Syst. 2016;14(1):1–9.CrossRef

27.

Lovelace KA, Aronson RE, Rulison KL, Labban JD, Shah GH, Smith M. Laying the groundwork for evidence-based public health: why some local health departments use more evidence-based decision-making practices than others. Am J Public Health. 2015;105(S2):S189–97.PubMedPubMedCentralCrossRef

28.

Jacob RR, Baker EA, Allen P, Dodson EA, Duggan K, Fields R, et al. Training needs and supports for evidence-based decision making among the public health workforce in the United States. BMC Health Serv Res. 2014;14(1):1–12.CrossRef

29.

Brownson RC, Reis RS, Allen P, Duggan K, Fields R, Stamatakis KA, et al. Understanding administrative evidence-based practices: findings from a survey of local health department leaders. Am J Prev Med. 2014;46(1):49–57.PubMedPubMedCentralCrossRef

30.

Jacobs JA, Clayton PF, Dove C, Funchess T, Jones E, Perveen G, et al. A survey tool for measuring evidence-based decision making capacity in public health agencies. BMC Health Serv Res. 2012;12(1):1–9.CrossRef

31.

Andermann A, Pang T, Newton JN, Davis A, Panisset U. Evidence for health II: overcoming barriers to using evidence in policy and practice. Health Res Policy Syst. 2016;14(1):17.PubMedPubMedCentralCrossRef

32.

Williams B, Perillo S, Brown T. What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review. Nurse Educ Today. 2015;35(2):e34–41.PubMedCrossRef

33.

Merlo G, Page K, Ratcliffe J, Halton K, Graves N. Bridging the gap: exploring the barriers to using economic evidence in healthcare decision making and strategies for improving uptake. Appl Health Econ Health Policy. 2015;13:303–9.PubMedCrossRef

34.

Van Epps A, Phillips M, Zwicky D, Johnson N. Effective methods of engineering information literacy: initial steps of a systematic literature review and observations about the literature. 2018.

35.

Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012;22(10):1435–43.PubMedCrossRef

36.

Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions version 5.1. 0 [updated March 2011]. The Cochrane Collaboration; 2011. Available from www.cochrane-handbookorg. 2013.

37.

Lewin S, Glenton C, Oxman AD. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ. 2009;339:b3496.PubMedPubMedCentralCrossRef

38.

Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med. 2015;8(1):2–10.PubMedCrossRef

39.

Jensen LA, Allen MN. Meta-synthesis of qualitative findings. Qual Health Res. 1996;6(4):553–60.CrossRef

40.

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8(1):45.PubMedPubMedCentralCrossRef

41.

Creswell JW. Educational research: planning, conducting, and evaluating quantitative and qualitative research. 2012.

42.

Corbin JM, Strauss A. Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol. 1990;13(1):3–21.CrossRef

43.

Wolfswinkel JF, Furtmueller E, Wilderom CP. Using grounded theory as a method for rigorously reviewing literature. Eur J Inf Syst. 2013;22(1):45–55.CrossRef

44.

Urquhart C. Exploring analyst-client communication: using grounded theory techniques to investigate interaction in informal requirements gathering. In: Lee AS, Liebenau J, DeGross JI, editors. Information Systems and Qualitative Research: Proceedings of the IFIP TC8 WG 82 International Conference on Information Systems and Qualitative Research, 31st May–3rd June 1997, Philadelphia, Pennsylvania, USA. Boston, MA: Springer US; 1997. p. 149–81.

45.

Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. Thousand Oaks, California; 2008. Available from: https://methods.sagepub.com/book/basics-of-qualitative-research.

46.

Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks: Sage Publications, Inc; 1998. p. xiii–312-xiii.

47.

Dubois A, Lévesque M. Public Health Network: Canada’s National Collaborating Centres: facilitating evidence-informed decision-making in public health. Can Commun Dis Rep. 2020;46(2–3):31.PubMedPubMedCentralCrossRef

48.

Anderson LM, Brownson RC, Fullilove MT, Teutsch SM, Novick LF, Fielding J, et al. Evidence-based public health policy and practice: promises and limits. Am J Prev Med. 2005;28(5):226–30.PubMedCrossRef

49.

Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health. 2009;30:175–201.PubMedCrossRef

50.

Schoemaker CG, van Loon J, Achterberg PW, den Hertog FR, Hilderink H, Melse J, et al. Four normative perspectives on public health policy-making and their preferences for bodies of evidence. Health Res Policy Syst. 2020;18(1):1–7.CrossRef

51.

Jacobs JA, Jones E, Gabella BA, Spring B, Brownson RC. Peer reviewed: tools for implementing an evidence-based approach in public health practice. Prev Chron Dis. 2012;9:E116.

52.

Sosnowy CD, Weiss LJ, Maylahn CM, Pirani SJ, Katagiri NJ. Factors affecting evidence-based decision making in local health departments. Am J Prev Med. 2013;45(6):763–8.PubMedCrossRef

53.

Armstrong R, Waters E, Dobbins M, Anderson L, Moore L, Petticrew M, et al. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan. Implement Sci. 2013;8:1–10.CrossRef

54.

Armstrong R, Waters E, Moore L, Dobbins M, Pettman T, Burns C, et al. Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting. Implement Sci. 2014;9(1):1–11.CrossRef

55.

Brownson RC, Fielding JE, Green LW. Building capacity for evidence-based public health: reconciling the pulls of practice and the push of research. Annu Rev Public Health. 2018;39:27–53.PubMedCrossRef

56.

Lillefjell M, Knudtsen MS, Wist G, IhlebÆK C. From knowledge to action in public health management: experiences from a Norwegian context. Scand J Public Health. 2013;41(8):771–7.PubMedCrossRef

57.

Peirson L, Ciliska D, Dobbins M, Mowat D. Building capacity for evidence informed decision making in public health: a case study of organizational change. BMC Public Health. 2012;12(1):1–13.CrossRef

58.

Traynor R, Dobbins M, DeCorby K. Challenges of partnership research: insights from a collaborative partnership in evidence-informed public health decision making. Evid Policy. 2015;11(1):99–109.CrossRef

59.

Ward M. Evidence-informed decision making in a public health setting. Healthc Manage Forum. 2011;24(1_suppl):S8–11.PubMedCrossRef

60.

Busert LK, Mütsch M, Kien C, Flatz A, Griebler U, Wildner M, et al. Facilitating evidence uptake: development and user testing of a systematic review summary format to inform public health decision-making in German-speaking countries. Health Res Policy Syst. 2018;16(1):59.PubMedPubMedCentralCrossRef

61.

Yost J, Dobbins M, Traynor R, DeCorby K, Workentine S, Greco L. Tools to support evidence-informed public health decision making. BMC Public Health. 2014;14(1):1–13.CrossRef

62.

McAneney H, McCann JF, Prior L, Wilde J, Kee F. Translating evidence into practice: a shared priority in public health? Soc Sci Med. 2010;70(10):1492–500.PubMedCrossRef

63.

Dobbins M, Jack S, Thomas H, Kothari A. Public health decision-makers’ informational needs and preferences for receiving research evidence. Worldviews Evid Based Nurs. 2007;4(3):156–63.PubMedCrossRef

64.

Frost H, Geddes R, Haw S, A. Jackson C, Jepson R, D. Mooney J, et al. Experiences of knowledge brokering for evidence-informed public health policy and practice: three years of the Scottish Collaboration for Public Health Research and Policy. Evid Policy. 2012;8(3):347–59.CrossRef

65.

Hardy AK, Nevin-Woods C, Proud S, Brownson RC. Peer reviewed: promoting evidence-based decision making in a Local Health Department, Pueblo City-County, Colorado. Prev Chronic Dis. 2015;12::E100.PubMedCrossRef

66.

Duggan K, Aisaka K, Tabak RG, Smith C, Erwin P, Brownson RC. Implementing administrative evidence based practices: lessons from the field in six local health departments across the United States. BMC Health Serv Res. 2015;15:1–9.CrossRef

67.

Pappaioanou M, Malison M, Wilkins K, Otto B, Goodman RA, Churchill RE, et al. Strengthening capacity in developing countries for evidence-based public health: the data for decision-making project. Soc Sci Med. 2003;57(10):1925–37.PubMedCrossRef

68.

Smith KE, Joyce KE. Capturing complex realities: understanding efforts to achieve evidence-based policy and practice in public health. Evid Policy. 2012;8(1):57–78.CrossRef

69.

Plath D. Organizational processes supporting evidence-based practice. Adm Soc Work. 2013;37(2):171–88.CrossRef

70.

Rousseau DM, Gunia BC. Evidence-based practice: the psychology of EBP implementation. Annu Rev Psychol. 2016;67:667–92.PubMedCrossRef

71.

Spiri WC, MacPhee M. The meaning of evidence-based management to Brazilian Senior Nurse Leaders. J Nurs Scholarsh. 2013;45(3):265–72.PubMedCrossRef

72.

Van Der Heide I, Van Der Noordt M, Proper KI, Schoemaker C, Van Den Berg M, Hamberg-van Reenen HH. Implementation of a tool to enhance evidence-informed decision making in public health: identifying barriers and facilitating factors. Evid Policy J Res Debate Pract. 2016;12(2):183–97.CrossRef

73.

Wright AL, Zammuto RF, Liesch PW, Middleton S, Hibbert P, Burke J, et al. Evidence-based management in practice: opening up the decision process, decision-maker and context. Br J Manag. 2016;27(1):161–78.CrossRef

74.

Martelli PF. An argument for knowledge variety in evidence-based management. Berkeley: University of California; 2012.

75.

Kahn BK, Strong DM, Wang RY. Information quality benchmarks: product and service performance. Commun ACM. 2002;45(4):184–92.CrossRef

76.

Seffah A, Donyaee M, Kline R, Padda H. Usability measurement and metrics: a consolidated model. Softw Qual J. 2006;14:159–78.CrossRef

77.

LaPelle NR, Luckmann R, Simpson EH, Martin ER. Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study. BMC Public Health. 2006;6(1):1–13.CrossRef

78.

Crosswaite C, Curtice L. Disseminating research results-the challenge of bridging the gap between health research and health action. Health Promot Int. 1994;9(4):289–96.CrossRef

79.

Ross J. The use of economic evaluation in health care: Australian decision makers’ perceptions. Health Policy. 1995;31(2):103–10.PubMedCrossRef

80.

Lavis JN, Robertson D, Woodside JM, McLeod CB, Abelson J. How can research organizations more effectively transfer research knowledge to decision makers? Milbank Q. 2003;81(2):221–48.PubMedPubMedCentralCrossRef

81.

Bednall TC, E. Rafferty A, Shipton H, Sanders K, J. Jackson C. Innovative behaviour: how much transformational leadership do you need? Br J Manag. 2018;29(4):796–816.CrossRef

82.

Masood M, Afsar B. Transformational leadership and innovative work behavior among nursing staff. Nurs Inq. 2017;24(4):e12188.CrossRef

83.

Sethibe T, Steyn R. The mediating effect of organizational climate on the relationship between leadership styles and their components on innovative behaviour. J Entrepreneurship Innov Emerg Econ. 2018;4(1):22–32.

84.

Suifan TS, Abdallah AB, Al Janini M. The impact of transformational leadership on employees’ creativity: the mediating role of perceived organizational support. Manage Res Rev. 2018;41(1):113–32.

85.

Asbari M, Purwanto A, Ong F, Mustikasiwi A, Maesaroh S, Mustofa M, et al. Impact of hard skills, soft skills and organizational culture: lecturer innovation competencies as mediating. EduPsyCouns. 2020;2(1):101–21.

86.

Fayzhall M, Purwanto A, Asbari M, Goestjahjanti FS, Winanti W, Yuwono T, et al. Transformational versus transactional Leadership: Manakah yang Mempengaruhi Kepuasan Kerja Guru? EduPsyCouns. 2020;2(1):256–75.

87.

Fikri MAA, Asbari M, Purwanto A, Nugroho YA, Waruwu H, Fauji A, et al. A mediation role of organizational of learning on relationship of hard skills, soft skills, innovation and performance: evidence at Islamic school. EduPsyCouns. 2020;2(1):398–423.

88.

Majdzadeh R, Sadighi J, Nejat S, Mahani AS, Gholami J. Knowledge translation for research utilization: design of a knowledge translation model at Tehran University of Medical Sciences. J Contin Educ Heal Prof. 2008;28(4):270–7.CrossRef

89.

Sedighi Z, Majdzadeh S, Nejat S, Fotouhi A, Shahidzadeh A, Gholami Z, et al. Knowledge translation: a model for research utilization. 2008.

90.

Tajedini O, Musavi A, Babalhavaeji F. Knowlege & knowlege translation. Tehran: Ketabdar; 2015. p. 14–30.

91.

Gholami J, Majdzadeh R, Nedjat S, Nedjat S, Maleki K, Ashoorkhani M, et al. How should we assess knowledge translation in research organizations; designing a knowledge translation self-assessment tool for research institutes (SATORI). Health Res Policy Syst. 2011;9(1):1–8.CrossRef

92.

Straus SE, Tetroe JM, Graham ID. Knowledge translation is the use of knowledge in health care decision making. J Clin Epidemiol. 2011;64(1):6–10.PubMedCrossRef

93.

Dakhesh S, Ostovar A, Hamidi A. From transfer of research question to promoting the use of evidence in the process of knowledge translation: self-assessment of researchers in Bushehr University of Medical Sciences. ISMJ. 2018;21(2):134–46.

94.

Alipour F, Idris K, Karimi R. Knowledge creation and transfer: role of learning organization. Int J Bus Adm. 2011;2(3):61.

95.

Argote L, Fahrenkopf E. Knowledge transfer in organizations: the roles of members, tasks, tools, and networks. Organ Behav Hum Decis Process. 2016;136:146–59.CrossRef

96.

Argote L, Ingram P. Knowledge transfer: a basis for competitive advantage in firms. Organ Behav Hum Decis Process. 2000;82(1):150–69.CrossRef

97.

McInerney M. Tacit knowledge transfer with patent law: exploring clean technology transfers. Fordham Intell Prop Media Ent LJ. 2010;21:449.

98.

Cabrera EF, Cabrera A. Fostering knowledge sharing through people management practices. Int J Hum Res Manage. 2005;16(5):720–35.CrossRef

99.

Salama-Carr M, Liyanage C, Elhag T, Ballal T, Li Q. Knowledge communication and translation–a knowledge transfer model. Frankfurt am Main: J Knowl Manage; 2009. p. 118–31.

100.

Innvaer S, Vist G, Trommald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7(4):239–44.PubMedCrossRef

101.

Lavis J, Davies H, Oxman A, Denis J-L, Golden-Biddle K, Ferlie E. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10(1_suppl):35–48.PubMedCrossRef

102.

Hamel N, Schrecker T. Unpacking capacity to utilize research: a tale of the Burkina Faso public health association. Soc Sci Med. 2011;72(1):31–8.PubMedCrossRef

103.

Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence based practice: a conceptual framework. BMJ Qual Saf. 1998;7(3):149–58.CrossRef

104.

Erwin PC, Harris JK, Smith C, Leep CJ, Duggan K, Brownson RC. Evidence-based public health practice among program managers in local public health departments. J Public Health Manag Pract. 2014;20(5):472–80.PubMedPubMedCentralCrossRef

Title: Challenges of using evidence in managerial decision-making of the primary health care system
Authors: Marjan Hedayatipour
Sina Etemadi
Somayeh Noori Hekmat
Alisadat Moosavi
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Public Health
Published in: BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-10409-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Challenges of using evidence in managerial decision-making of the primary health care system

Abstract

Background

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusion

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