Multifactorial barriers in the implementation of schizophrenia and psychosocial therapies guidelines: A quantitative study across different professions
- PMID: 33561620
- DOI: 10.1016/j.schres.2021.01.010
Multifactorial barriers in the implementation of schizophrenia and psychosocial therapies guidelines: A quantitative study across different professions
Abstract
Background: Clinical guidelines can facilitate the transfer of scientific evidence into clinical practice, yet their implementation still faces difficulties. The aim of this study was to examine the implementation status of the current German evidence- and consensus-based guidelines for schizophrenia (2019) and psychosocial therapies (2019) and to identify barriers as well as facilitators in guideline adherence.
Methods: We used a quantitative approach by developing an online questionnaire, focusing on the current implementation status as well as barriers and facilitators in guideline adherence. The questionnaire was sent to 100 hospitals for psychiatry and psychosomatics and 52 professional associations in mental healthcare in Germany (investigation period: 10/2019-01/2020).
Results: In total, 657 mental healthcare professionals (MHCP, e.g. medical doctors, psychologists, psychosocial therapists, caregivers) provided sufficient responses for analyses. Less than half (47%) of our participants were aware of the existence of the guideline for psychosocial therapies, while 74% exhibited awareness of the schizophrenia guideline. A minority reported to adhere to the current guidelines for schizophrenia (41%) and psychosocial interventions (18%). Profession-related differences in the implementation-status were detected. Specifically, medical doctors exhibited higher awareness rates than psychosocial therapists and caregivers and additionally higher adherence rates than psychologists and caregivers. Medical doctors were less exposed to knowledge-related barriers (e.g. lack of guideline familiarity), while no differences across professions were found in external/behavior-related barriers (e.g. long versions).
Discussion and conclusion: Our findings indicate that the implementation of guidelines as well as related barriers vary between professions. To prevent a growing gap in guideline adherence between MHCP, target-specific implementation strategies should be considered.
Keywords: Barrier; Guideline; Implementation; Profession; Psychosocial therapies; Schizophrenia.
Copyright © 2021 Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest Gabriele Gaigl, Esther Täumer, Katharina Merz, Sabina Zöscher, Sarah Wagner and Markus Kösters report no conflicts of interest. Peter Falkai was honorary speaker for Janssen-Cilag, Astra-Zeneca, Eli Lilly, Bristol Myers-Squibb, Lundbeck, Pfizer, Bayer Vital, SmithKline Beecham, Wyeth, and Essex. During the last 5 years, he was a member of the advisory boards of Janssen-Cilag, Astra-Zeneca, Eli Lilly, and Lundbeck. Presently, he is a member of the advisory boards of Richter Pharma, Abbot, and Otsuka. Stefan Leucht has received in the last 3 years honoraria for service as a consultant or adviser and/or for lectures from Angelini, Böhringer Ingelheim, Geodon&Richter, Janssen, Johnson&Johnson, Lundbeck, LTS Lohmann, MSD, Otsuka, Recordati, SanofiAventis, Sandoz, Sunovion, TEVA. Alkomiet Hasan has been invited to scientific meetings by Lundbeck, Janssen, and Pfizer, and he received paid speakerships from Desitin, Janssen, Otsuka, and Lundbeck. He was member of Roche, Otsuka, Lundbeck, and Janssen advisory boards.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous
