Department of Psychiatry, Psychotherapy and Psychosomatic, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany.
Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Medical Faculty, Klinikum Rechts der Isar, 81675, Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2023 Oct;273(7):1587-1598. doi: 10.1007/s00406-023-01568-z. Epub 2023 Feb 18.
The implementation status of clinical guidelines is, despite their important role in connecting research with practice, frequently not satisfactory. This study aims to investigate the implementation status of the current German guideline for schizophrenia. Moreover, the attitude toward a living guideline has been explored for the first time by presenting screenshots of the German schizophrenia guideline transferred to a digital living guideline format called MAGICapp. A cross-sectional online survey was performed under the participation of 17 hospitals for psychiatry and psychosomatic medicine in Southern Germany and one professional association for German neurologists and psychiatrists. 439 participants supplied sufficient data for analysis. 309 provided complete data sets. Regarding the current guideline for schizophrenia and key recommendations, a large awareness-to-adherence gap was found. Group comparisons between different professions (caregivers, medical doctors, psychologists/psychotherapists, psychosocial therapists) detected differences in the implementation status showing higher awareness and agreement with the schizophrenia guideline and its key recommendations among medical doctors compared to psychosocial therapists and caregivers. Moreover, we detected differences in the implementation status of the guideline as a whole and its key recommendations between specialist and assistant doctors. The attitude toward an upcoming living guideline was mostly positive, especially among younger healthcare professionals. Our findings confirm an awareness-to-adherence gap, not only for the current schizophrenia guideline in general but also for its key recommendations with apparent differences between professions. Overall, our results show promising positive attitudes toward the living guideline for schizophrenia among healthcare providers, suggesting that a living guideline may be a supportive tool in everyday clinical practice.
尽管临床指南在连接研究与实践方面具有重要作用，但实际上其实施情况并不尽如人意。本研究旨在调查当前德国精神分裂症指南的实施情况。此外，我们还首次通过展示德国精神分裂症指南的屏幕截图，探索了对活指南的态度。研究采用横断面在线调查的方法，邀请了德国南部 17 家精神病和身心医学医院以及一家德国神经病学和精神病学专业协会参与。共有 439 名参与者提供了足够的分析数据。其中 309 名参与者提供了完整的数据集。在当前的精神分裂症指南和关键建议方面，我们发现了认知与实践之间存在较大差距。不同专业人员（护理人员、医生、心理学家/心理治疗师、心理社会治疗师）之间的组间比较显示，与心理社会治疗师和护理人员相比，医生对精神分裂症指南及其关键建议的认知和认同度更高。此外，我们还发现了整个指南及其关键建议在专业医生和助理医生之间的实施情况存在差异。对即将推出的活指南的态度大多是积极的，尤其是在年轻的医疗保健专业人员中。我们的研究结果证实了认知与实践之间存在差距，不仅针对当前的精神分裂症指南，而且针对其关键建议，不同专业之间存在明显差异。总体而言，我们的研究结果表明，医疗保健提供者对精神分裂症活指南持积极态度，这表明活指南可能是日常临床实践中的一种支持工具。
