Abstract
Background: Evidence-based medicine (EBM) improves quality by ensuring clinical decisions are based on the latest, most reliable evidence, leading to better patient outcomes, reduced practice variability, and safer care. It fosters continuous learning and the adoption of effective interventions tailored to individual patients. Despite its recognized importance, physicians may encounter cognitive barriers (e.g., limited research literacy), organizational barriers (e.g., workload and time constraints), and resource-related barriers (e.g., limited access to specialized databases) that hinder consistent integration into daily decision-making. Limited data are available regarding EBM implementation in the Aseer Region of Saudi Arabia. Objective: To assess the level of EBM implementation among practicing physicians in Abha, identify perceived barriers, and compare EBM utilization between government teaching hospitals and private hospitals. Methods: This analytical cross-sectional study involved 273 physicians from major government and private hospitals in Abha. Data were collected using a validated 27-item questionnaire covering demographics, daily information-seeking practices, attitudes toward EBM, and perceived barriers. Descriptive statistics, independent-samples t-tests, and Pearson correlation coefficients were employed to evaluate determinants of EBM practice. Results: Most participants were males (71.8%), aged 25-35 years (57.5%), employed in government hospitals (86.4%), and had less than 10 years of experience (68.9%). The median proportion of daily practice based on EBM was 50% (IQR: 10-80). While attitudes toward EBM were strongly positive-particularly regarding its role in improving patient care and work quality-the actual use of high-quality databases (Cochrane, Embase, Web of Science) remained limited. PubMed and clinical guidelines were the most frequently consulted resources. The most commonly reported barriers were limited time and the belief that research findings may not be universally applicable. Positive attitudes showed a moderate correlation with higher EBM use (r = 0.35-0.42, p < 0.001). No significant difference in EBM integration was observed between government and private hospitals (p = 0.511). Conclusions: Physicians in Abha demonstrate positive attitudes toward EBM; however, actual use in clinical practice remains moderate and is hindered by time constraints and perceived challenges in applying research to practice. Enhancing access to evidence resources, improving research literacy, and integrating EBM into daily workflows may promote more consistent use in clinical care.