Department of Psychiatry and Psychotherapy, Klinikum Rechts Der Isar, School of Medicine, Medical Faculty, Technical University of Munich, 81675, Munich, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatic, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2024 Sep;274(6):1483-1496. doi: 10.1007/s00406-023-01663-1. Epub 2023 Aug 15.
This study aims to investigate the barriers and facilitators to guideline adherence for the print format of the German schizophrenia guideline as well as for the concept of a digital living guideline for the first time. For this purpose, the schizophrenia guideline was transferred to a digital guideline format within the web-based tool MAGICapp. An online survey was performed under participation of mental healthcare professionals (medical doctors, psychologists/psychotherapists, psychosocial therapists, caregivers) in 17 hospitals for psychiatry in Southern Germany and a professional association for German neurologists and psychiatrists. 524 participants opened the survey, 439 completed the demographic questions and commenced the content-related survey and 309 provided complete data sets. Results indicate a higher occurrence of knowledge-related barriers for the living guideline. The print version is associated with more attitude-related and external barriers. Older professionals reported more attitude-related barriers to a living guideline compared to younger professionals. Differences between professions regarding barriers were found for both formats. Various barriers exist for both guideline formats and a need for facilitators was expressed across professions. Many of the mentioned obstacles and facilitators can be more easily addressed with living guidelines. However, also living guidelines face barriers. Thus, the introduction of these new formats alone cannot lead to sustainable behavior change regarding guideline adherence. Yet, living guidelines seem to be a cornerstone to improved and tailored guideline implementation as they facilitate to keep recommendations up to date and to address the need of individual professional groups.
本研究旨在首次调查遵循德国精神分裂症指南印刷格式以及遵循数字生活指南的障碍和促进因素。为此，在基于网络的 MAGICapp 工具中，将精神分裂症指南转换为数字指南格式。在德国南部 17 家精神病院和德国神经病学家和精神病学家专业协会中，邀请精神卫生保健专业人员（医生、心理学家/心理治疗师、心理社会治疗师、护理人员）参与在线调查。524 名参与者打开了调查，439 名参与者完成了人口统计学问题并开始进行内容相关的调查，309 名参与者提供了完整的数据集。结果表明，生活指南的知识相关障碍发生率更高。印刷版与更多的态度相关和外部障碍相关。与年轻专业人员相比，年长的专业人员报告说，生活指南的态度相关障碍更多。两种格式都发现了专业之间的障碍差异。两种指南格式都存在各种障碍，不同专业都表达了对促进因素的需求。许多提到的障碍和促进因素在使用生活指南时可以更容易解决。然而，生活指南也面临障碍。因此，仅引入这些新格式本身并不能导致遵循指南方面的可持续行为改变。然而，生活指南似乎是改善和定制指南实施的基石，因为它们有助于使建议保持最新，并满足个别专业群体的需求。
