Saskatchewan Residents’ Use of The Cochrane Library

There is strong evidence of failure to translate research findings into the health care decision-making process of consumers, practitioners and policy makers (Grimshaw, 2007). Recognizing that The Cochrane Database of Systematic Reviews contained in The Cochrane Library (the Library) are the “gold standard” of systematic reviews, Saskatchewan’s Health Quality Council provided funding for a provincial license and an evaluation study. In July 2004, Saskatchewan became the first province in Canada to provide all residents with access to the Library. The primary aim of the study was to enhance and evaluate the use of the Library over three years. Since September 2004, over 46 training sessions have been conducted on searching the Library online databases. Attendees at the workshops were informed of the evaluation study and invited to participate. Those who consented to participate were telephoned following the workshops and audio-taped interviews were conducted. Usage of the Library was also tracked using data available from Wiley InterScience. Three month (n=94), six month (n=71), nine month (n=79), and 12 month (n=72) telephone interviews were conducted. Most participants were librarians (n=31.5%), followed by nurses (16.3%), therapists (7.6%), library support staff (5.4%), pharmacists (4.3%), physicians (3.3%), and others (30.5). Most were between 40 to 65 years of age (71.6%) and female (92.4%). Most respondents had accessed the Library at the three-month (65.2%) and six-month (64.2%) follow-up interviews. However, this percent fell to 45.2% at the nine-month and 27.4% at the twelve-month interview. MeSH searches were more frequent than standard keyword searches and HTML full text retrievals were more common than PDF versions. It is assumed that HTML versions were scanned for particular information whereas PDF versions were selected when the person wished to save and read the whole review. Librarians, practitioners and consumers are more likely to be scanning a review for specific information whereas students and researchers may wish to save and read the whole review. At the three-month interview, 16.4% did not find the Library helpful. However, this percent decreased to 11.6% by the six-month, 7.7% in the nine-month and 11.8% in the twelve-month interview. Most respondents (57.5%) claimed to have learned something from the Library; others reported that the knowledge gained helped in their decision-making (32.6%) or confirmed their beliefs (26.1%). Respondents’ primary reason for accessing the Library was in response to patron requests for information on medications, herbal therapies, lifestyle modifications, injury prevention, assessments, and treatments related to chronic conditions such as diabetes, heart condition, cancer, and arthritis. Information was used to support changes in health care practice and policy and for the preparation of educational papers, handouts, and presentations. The primary reasons for not using the Library were lack of time, limited access to an internet ready computer in the work setting, reliance on dial-up internet in some rural areas, forgetting how to find and navigate the website, and being disappointed with information available in the Library. The plain language summaries were well received, however, some felt the sophisticated language and length of the reviews were more appropriate for researchers and healthcare providers than the general public. Understanding the frequency of use and reasons why and why not consumers, practitioners, and policy makers access the Library will assist in meeting their needs and promoting the use of the Library. Only when health care providers and consumers use the best available research evidence will improvements be made in health outcomes