Leitlinien in der Medizin : Evaluierung der S2-Leitlinie Parkinson-Syndrome

Objective: The increasingly diverse options for diagnostics and therapy of Parkinsons Disease require reliable standards for patient care, which are based on current scientific knowledge. Since attitudes and barriers of Clinical Practice Guidelines (CPGs) in one setting may not be present in another setting, this study evaluated the awareness, acceptance and implementation of the CPG on Parkinsons Disease (CPG-PD) and of guidelines in general in inpatient setting in contrary to outpatient setting. Methods: Cross-sectional study and expert interviews. 70 neurologists working in hospitals were asked by an 48-item questionnaire about acceptance, utility, barriers and implementation of the CPG-PD and of CPGs in general. Secondly, 8 expert interviews were conducted to compare neurologists working in inpatient care with neurologists working in outpatient care. Results: 84,5% (n=60) of the neurologists were aware of the CPG-PD, 92,9% (n=52) found it beneficial, and 93,4% (n=56) applied it in daily practice. 44,4% (n=24) estimated an improvement in the quality of care. Positive aspects of the CPG-PD concerned “clearness” (n=16), “structure” (n=17) and “quality” (n=16). Main point of criticism was the lack of actuality (n=5). 53,5% (n=38) of the neurologists were against a special guideline for patients. Most neurologists agreed on positive attitudes towards guidelines in general: They stated that guidelines are intended to improve the quality of care (94,3%; n=66). Main barriers to guideline implementation were the lack of actuality (39,5%; n=28), uncertain juridical position (38,1%; n=27) and the lack of knowledge (36,7%; n=26). Qualitative data-analysis revealed no important differences between the attitudes of neurologists working in inpatient and outpatient care. Both groups agreed on, that guidelines are easier to apply in inpatient settings than in outpatient settings. Conclusions: Both the quantitative and the qualitative approach revealed a positive acceptance of the CPG-PD in inpatient settings and outpatient settings. The overall attitude concerning guidelines in general was positive. Critical aspects demonstrated the need to enhance guideline development. Appropriate implementation strategies are needed for transfer CPGs into practice and for facilitating its use.