Translating psoriasis treatment guidelines into clinical practice - the need for educational interventions and strategies for broad dissemination.
BACKGROUND
Evidence-based guidelines can make a substantial contribution to improving medical care. However, it is important to ensure that guidelines are: (1) developed in areas in which they are needed the most; and (2) translated effectively into everyday clinical practice.


OBJECTIVE
To evaluate the need for guidelines in the treatment of psoriasis vulgaris, the success of the dissemination activities undertaken to date, and the potential benefits of educational interventions in encouraging guideline compliance.


METHODS
All dermatologists working in the Berlin-Brandenburg region of Germany were invited to attend a workshop on the psoriasis treatment guidelines. Participants could take part in a survey examining the general need for psoriasis guidelines and the success of previous dissemination activities.


RESULTS
A total of 42% of survey participants had not received a copy of the guidelines prior to the workshop. Of those who had received a copy, only 15% had studied the guidelines in detail. In total, 76% of survey participants felt that physicians' low levels of confidence in administering systemic treatments had resulted in these treatment options being used less frequently than they should. Seventy-nine per cent of survey participants believed that the guidelines would be helpful in improving physicians' confidence and ultimately lead to an increased use of systemic treatments.


CONCLUSIONS
The results of the present study indicate that there is a great need for guidelines on the treatment of psoriasis vulgaris in Germany, especially in light of dermatologists' low levels of confidence administering systemic treatments. Strategies for broad dissemination are essential for proper guideline implementation.
Nast
Alexander
A
Division of Evidence Based Medicine, Klinik für Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany. alexander.nast@charite.de
Erdmann
Ricardo
R
Pathirana
Delano
D
Rzany
Berthold
B
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001604:Berlin; D002983:Clinical Competence; D003879:Dermatologic Agents / Q000627:therapeutic use; D003880:Dermatology / Q000193:education* / Q000458:organization & administration; D004059:Diffusion of Innovation; D004502:Education, Medical, Continuing; D019317:Evidence-Based Medicine / Q000193:education* / Q000458:organization & administration; D005650:Fumarates / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D033181:Information Dissemination / Q000379:methods; D020380:Needs Assessment / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011565:Psoriasis / Q000188:drug therapy; D012074:Remission Induction; D020377:Self Efficacy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005650:Fumarates; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha