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Family doctor, Dr Igor Zastavnyy, tells us about his experience of the Clinical Decision Support Training Initiative.

“BMJ Best Practice has helped me to practice in line with evidence-based guidelines. I now rely on the information it provides and refer to it all the time.”
Dr Igor Zastavnyy, Ambulatory of Family Medicine, Ukraine

The challenges of evidence-based medicine

Before accessing the evidence-based guidelines in BMJ Best Practice, my practice was very different. In the past I have mainly referred to local guidelines, however, they are not always updated. Some are over 10 years old and do not reflect the latest evidence-based guidance.

Keeping up with the guidelines is a big challenge. There are over 50 that I need to refer to in my clinical practice and many are very long. It takes me about a half day to a day to learn one guideline thoroughly and I will look at them monthly to refresh my knowledge.

Due to these limitations, I make decisions daily that are not fully in line with our local guidelines.

BMJ Best Practice has helped me to practice in line with evidence-based guidelines. I now rely on the information it provides and refer to it all the time.”

Applying learning to practice

BMJ Best Practice is very quick and efficient to refer to in a patient consultation as I can simply login and get the guidance I need. I especially like the patient leaflets and have translated some of them to give to my patients.

Since accessing BMJ Best Practice, I have applied the new knowledge in my clinical practice on a number of occasions.

For example, I am now treating chronic heart failure according to the evidence-based recommendations outlined in BMJ Best Practice. I am also using digoxin less as it doesn’t improve longevity and I am also now using beta blockers appropriately. In patients with type 2 diabetes, I now understand step-by-step treatment, how to use drugs appropriately and when to add new drugs.

And in chronic obstructive pulmonary disease, I have changed how I make the diagnosis according to the BMJ Best Practice.

I now use peak flow measurement and spirometry in diagnosis. In addition, I like the simplicity of the content on cardiology. I can easily find the step-by-step guidance I need and put it straight into practice.

Recently, I saw a young patient with rheumatoid arthritis. She had visited other clinics and was receiving treatment with methotrexate but it wasn’t helping her pain. She had seen a few different doctors who had all continued the same treatment.

According to the guidelines on the BMJ Best Practice, I saw that I could try combination therapy for her. I have started this and her condition is now much improved.”

“I think doctors throughout Ukraine could benefit from access to BMJ Best Practice. I would like to see more of the BMJ Best Practice topics translated into Ukrainian so they would be more accessible for all doctors.”

Learn more

BMJ CLINICAL DECISION SUPPORT TRAINING INITIATIVE

To find out more or share your own success stories, contact

Lalitha Bhagavatheeswaran
Programme Manager, BMJ Global Health Initiatives