[To what extent are recommendations of guidelines relevant in everyday practice? An essential question for evaluation studies].

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.