de Wit N J, Mendive J, Seifert B, Cardin F, Rubin G
Julius Centre for General Practice and Patient Oriented Research, UMC, Utrecht, The Netherlands.
Fam Pract. 2000 Aug;17 Suppl 2:S27-32. doi: 10.1093/fampra/17.suppl_2.s27.
Clinical guideline programmes as being developed in many European countries contribute to quality of care in general practice. The applicability of multicountry guidelines will depend on country-specific circumstances. Implementation programmes are required for optimal compliance with guidelines.
In order to achieve optimal follow-up of the European Society for Primary Care Gastroenterology (ESPCG) Helicobacter pylori guidelines in general practice, we analysed factors that might obstruct compliance at national level, and integrated this in implementation programmes.
Discussion groups in eight participating countries reviewed epidemiological characteristics and diagnostic and therapeutic resources that would hinder applicability. The groups also indicated potential constraints to optimal compliance and developed a national implementation programme.
Helicobacter pylori infection rates and peptic ulcer incidence vary widely across Europe, as do the availability, access and reimbursement of diagnostic test facilities for H.pylori Minor adaptation of the ESPCG guidelines is required in some countries. Implementation programmes have been developed and partially carried out in all countries.
A pan-European approach to H.pylori guideline development should result in a framework of best practice into which nationally specific details can be incorporated, thus guaranteeing optimal follow-up of the guidelines and true improvement of dyspepsia management in primary care.
许多欧洲国家正在制定的临床指南项目有助于提高全科医疗的护理质量。多国指南的适用性将取决于各国的具体情况。为了最佳地遵循指南，需要实施相关项目。
为了在全科医疗中实现对欧洲初级保健胃肠病学学会（ESPCG）幽门螺杆菌指南的最佳跟进，我们分析了可能在国家层面阻碍遵循指南的因素，并将其纳入实施项目中。
八个参与国的讨论小组审查了可能阻碍指南适用性的流行病学特征以及诊断和治疗资源。这些小组还指出了最佳遵循指南的潜在限制，并制定了国家实施项目。
欧洲各国的幽门螺杆菌感染率和消化性溃疡发病率差异很大，幽门螺杆菌诊断检测设施的可获得性、可及性和报销情况也是如此。一些国家需要对ESPCG指南进行轻微调整。所有国家都已制定并部分实施了实施项目。
采用泛欧洲方法制定幽门螺杆菌指南应能形成一个最佳实践框架，在其中可以纳入各国的具体细节，从而确保最佳地遵循指南，并真正改善初级保健中消化不良的管理。
