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[To what extent are recommendations of guidelines relevant in everyday practice? An essential question for evaluation
Liselotte von Ferber1, Christian von Ferber
1Forschunsgruppe Primärmedizinische Versorgung an der Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Köln. c.vonFerber@uni-duesseldorf.de
Purpose:
To what extent are recommendations of guidelines relevant in everyday practice?
Methods:
142 general practitioners (GPs) participating in ten different quality circles administered by the statutory medical association of Hesse were interviewed by questionnaire, which of 135 recommendations selected from eight guidelines they had used during the last 6 weeks. The guidelines proposed recommendations for eight frequent indications in primary care. The findings were presented to 15 authors of the guidelines. The authors were asked to assess each recommendation as essential, important or nonessential to therapy.
Results:
By setting a benchmark of 75% for adherence to each recommendation, 50% of all recommendations had been used by the GPs. With very few exceptions the authors of the guidelines assessed these recommendations as essential or important to therapy. On the other hand, many recommendations that missed the benchmark were assessed as nonessential by the authors.
Conclusion:
Recommendations of guidelines should be systematically assessed by users and authors together to find out which of them are really of clinical relevance.
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