The impact of a digital guideline version on schizophrenia guideline knowledge: results from a multicenter cluster-randomized controlled trial

  • Background Clinical practice guidelines are crucial for enhancing healthcare quality and patient outcomes. Yet, their implementation remains inconsistent across various professions and disciplines. Previous findings on the implementation of the German guideline for schizophrenia (2019) revealed low adherence rates among healthcare professionals. Barriers to guideline adherence are multifaceted, influenced by individual, contextual, and guideline-related factors. This study aims to investigate the effectiveness of a digital guideline version compared to print/PDF formats in enhancing guideline adherence. Methods A multicenter, cluster-randomized controlled trial was conducted in South Bavaria, Germany, involving psychologists and physicians. Participants were divided into two groups: implementation of the guideline using a digital online version via the MAGICapp platform and the other using the traditional print/PDF version. The study included a baseline assessment and aBackground Clinical practice guidelines are crucial for enhancing healthcare quality and patient outcomes. Yet, their implementation remains inconsistent across various professions and disciplines. Previous findings on the implementation of the German guideline for schizophrenia (2019) revealed low adherence rates among healthcare professionals. Barriers to guideline adherence are multifaceted, influenced by individual, contextual, and guideline-related factors. This study aims to investigate the effectiveness of a digital guideline version compared to print/PDF formats in enhancing guideline adherence. Methods A multicenter, cluster-randomized controlled trial was conducted in South Bavaria, Germany, involving psychologists and physicians. Participants were divided into two groups: implementation of the guideline using a digital online version via the MAGICapp platform and the other using the traditional print/PDF version. The study included a baseline assessment and a post-intervention assessment following a 6-month intervention phase. The primary outcome was guideline knowledge, which was assessed using a guideline knowledge questionnaire. Results The study included 217 participants at baseline and 120 at post-intervention. Both groups showed significant improvements in guideline knowledge; however, no notable difference was found between both study groups regarding guideline knowledge at either time points. At baseline, 43.6% in the control group (CG) and 52.5% of the interventional group (IG) met the criterion. There was no significant difference in the primary outcome between the two groups at either time point (T0: Chi2(1) = 1.65, p = 0.199, T1: Chi2(1) = 0.34, p = 0.561). At post-intervention, both groups improved, with 58.2% in the CG and 63.5% in the IG meeting this criterion. Conclusions While the study did not include a control group without any implementation strategy, the overall improvement in guideline knowledge following an implementation strategy, independent of the format, was confirmed. The digital guideline version, while not superior in enhancing knowledge, showed potential benefits in shared decision-making skills. However, familiarity with traditional formats and various barriers to digital application may have influenced these results. The study highlights the importance of tailored implementation strategies, especially for younger healthcare providers.show moreshow less

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Author:Theresa HalmsORCiDGND, Gabriele GaiglGND, Carolin Lorenz, Duygu GülerGND, Naiiri Khorikian-GhazariGND, Astrid RöhORCiDGND, Angelika Burschinski, Wolfgang Gaebel, Marisa Flick, Charline Pielenz, Eva Salveridou-Hof, Thomas Schneider-Axmann, Marco Schneider, Elias WagnerGND, Peter Falkai, Susanne Lucae, Michael Rentrop, Peter Zwanzger, Florian Seemüller, Michael Landgrebe, Marion Ortner, Bertram Schneeweiß, Peter Brieger, Klemens Ajayi, Michael Schwarz, Stephan Heres, Nicolay Marstrander, Thomas Becker, Markus Jäger, Albert Putzhammer, Karel Frasch, Raimund Steber, Stefan Leucht, Alkomiet HasanORCiDGND
URN:urn:nbn:de:bvb:384-opus4-1147778
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/114777
ISSN:1741-7015OPAC
Parent Title (English):BMC Medicine
Publisher:Springer Science and Business Media LLC
Type:Article
Language:English
Year of first Publication:2024
Publishing Institution:Universität Augsburg
Release Date:2024/08/26
Volume:22
Issue:1
First Page:311
DOI:https://doi.org/10.1186/s12916-024-03533-6
Institutes:Medizinische Fakultät
Medizinische Fakultät / Lehrstuhl für Psychiatrie und Psychotherapie
Medizinische Fakultät / Professur für Evidenzbasierte Psychiatrie und Psychotherapie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)