| Does the clinical practice guideline on Parkinson's disease change health outcomes? A cluster randomized controlled trial. | |
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MedLine Citation:
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PMID: 21136272 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The successful transfer of clinical practice guidelines (CPGs) into patient care depends on the appropriateness of the implementation method. This study strived for a better understanding of which intervention strategy is effective in implementing the CPG on Parkinson's disease (CPG-PD). In a cluster randomized controlled trial, we compared the impact of two different implementation strategies of the CPG-PD on health outcomes of PD patients. The primary outcome of health-related quality of life was measured by PDQ-39. The neurologists of the intervention group (IG) versus a control group (CG) received the CPG-PD with special instructions, a 4-h training and were offered personal feedback. Patients were followed over three assessment times: baseline, post-test (6 months) and follow-up (9 months). Lack of time and remuneration resulted in low study participation (32 out of 619 contacted neurologists). Multilevel modelling revealed that primary (PDQ-39) and secondary efficacy variables (EQ-5D, CGI, HADS-D, ZUF-8) of 386 patients were not affected significantly by the intervention and failed to show any significant difference between the two groups. The EQ-5D VAS scale (p = 0.0288) and the CGI-P severity scale (p = 0.0072) showed a significant worsening over time. A significant decrease of hours of dyskinesias in the IG (p = 0.007) was observed, whereas Parkinson symptoms did not change significantly between the groups. Lacking awareness of the CPG-PD seems to be no longer a barrier for its use, but it is still a major challenge to find effective implementation methods to optimise clinical outcome. Further studies are needed for a more comprehensive understanding of successful implementation strategies. |
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Authors:
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Astrid Larisch; Alexander Reuss; Wolfgang H Oertel; Karla Eggert |
Publication Detail:
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Type: Journal Article Date: 2010-12-07 |
Journal Detail:
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Title: Journal of neurology Volume: 258 ISSN: 1432-1459 ISO Abbreviation: J. Neurol. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: Germany |
Other Details:
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Languages: eng Pagination: 826-34 Citation Subset: IM |
Affiliation:
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Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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