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Implementation of the German Clinical Practice Guideline for Multimorbidity Using a Digital Tool in Primary Care:
Julia Nothacker1, Valentina Paucke1, Susanne Lezius2
1Institute and Outpatients Clinic of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
JMIR Aging
|November 20, 2025
Summary
Implementing clinical practice guidelines for multimorbidity using a digital tool is feasible. This approach may reduce hospital admissions and specialist visits while improving care quality for elderly patients.
Area of Science:
- Health Informatics
- Geriatric Medicine
- Evidence-Based Practice
Background:
- Clinical practice guidelines (CPGs) are crucial for summarizing evidence but require effective implementation.
- Information and communications technology can aid CPG implementation to improve patient-centered outcomes.
- Studies on the implementation of multimorbidity CPGs, especially using digital tools, are limited.
Purpose of the Study:
- To assess the feasibility of implementing a multimorbidity CPG via a digital tool.
- To explore the potential effects of this digital CPG implementation intervention.
Main Methods:
- A pilot cluster randomized trial involving 120 elderly patients (≥65 years) with at least two chronic conditions across 20 general practitioner (GP) practices.
- Comparison of a web application for CPG adherence against treatment as usual.
- Primary outcome: hospital time; secondary outcomes: hospital admissions, healthcare utilization, quality of life, patient satisfaction, and quality of care.
Main Results:
- Implementation was feasible with a 89% compliance rate.
- Hospital admission odds were reduced by nearly half in the intervention group (OR 0.51, P=.23).
- Improved quality of care reported by patients and GPs (P=.12 and P=.03, respectively).
Conclusions:
- Digital tool implementation of multimorbidity CPGs is feasible.
- Potential benefits include reduced hospital admissions, fewer specialist visits, and enhanced quality of care.
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