Multifactorial barriers in the implementation of schizophrenia and psychosocial therapies guidelines: A quantitative study across different professions

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Gabriele Gaigl - , Ludwig Maximilian University of Munich (Author)
  • Esther Täumer - , Ludwig Maximilian University of Munich (Author)
  • Katharina Merz - , Ludwig Maximilian University of Munich (Author)
  • Sabina Zöscher - , Ludwig Maximilian University of Munich (Author)
  • Sarah Wagner - , Ludwig Maximilian University of Munich (Author)
  • Markus Kösters - , Ulm University (Author)
  • Peter Falkai - , Ludwig Maximilian University of Munich (Author)
  • Stefan Leucht - , Technical University of Munich (Author)
  • Alkomiet Hasan - , Ludwig Maximilian University of Munich, Augsburg University (Author)

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.

Details

Original languageEnglish
Pages (from-to)425-434
Number of pages10
JournalSchizophrenia research
Volume228
Publication statusPublished - Feb 2021
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 33561620
ORCID /0000-0001-7018-6021/work/168207891

Keywords

Sustainable Development Goals

Keywords

  • Barrier, Guideline, Implementation, Profession, Psychosocial therapies, Schizophrenia