caa a22 4500 445810491 CHVBK 20180317145210.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00415-010-5848-1 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5848-1 Does the clinical practice guideline on Parkinson's disease change health outcomes? A cluster randomized controlled trial [Elektronische Daten] [Astrid Larisch, Alexander Reuss, Wolfgang Oertel, Karla Eggert] 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 (6months) and follow-up (9months). 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. Springer-Verlag, 2010 Clinical practice guideline nationallicence Parkinson's disease nationallicence Implementation nationallicence Quality of life nationallicence Larisch Astrid Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut Reuss Alexander Center for Clinical Trials, Philipps-University of Marburg, Karl-von-Frisch-Strasse 4, 35043, Marburg, Germany aut Oertel Wolfgang Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut Eggert Karla Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut Journal of Neurology Springer-Verlag 258/5(2011-05-01), 826-834 0340-5354 258:5<826 2011 258 415 https://doi.org/10.1007/s00415-010-5848-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5848-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Larisch Astrid Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut NATIONALLICENCE 700 1- Reuss Alexander Center for Clinical Trials, Philipps-University of Marburg, Karl-von-Frisch-Strasse 4, 35043, Marburg, Germany aut NATIONALLICENCE 700 1- Oertel Wolfgang Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut NATIONALLICENCE 700 1- Eggert Karla Department of Neurology, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/5(2011-05-01), 826-834 0340-5354 258:5<826 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer