Praktikabilität und akzeptanz der DEGAM-leitlinie " nackenschmerzen" im praxistest

Background: Guidelines by the German College of General Practitioners and Family Physicians (DEGAM) are systematically developed references. They build the basis of common decision making for physicians and their patients, which presents in a single case reasonable care. An important part of developing a new guideline is the field test in which practicability and acceptance are tested under field conditions by general practitioners (GPs). This field test deals with the reason for counseling "neck pain". The participating physicians can influence a future guideline with their perspective from the practice. Methods: 230 GPs in the area of Heidelberg were asked to participate in this field test. 20 GPs expressed their interest in taking part in the study. Participants were asked to critically read through the long version and the patient information, and to highlight in a copy positive and negative aspects of the short version. Additionally, they were asked to use the guideline in patients with neck pain in the following four weeks, and to participate in a focus group meeting. Results: From the 20 GPs who expressed their interest in taking part in the study, 14 (6% of all who have been asked) did participate. Especially for inexperienced physicians, this guideline was seen as a helpful addition. To improve the content, additions regarding injection therapy were suggested. Besides experienced pressure through patients for a quicker step up in diagnostics and therapy, lack of time and too little salary were the main reasons that stood practicability and acceptance in its way. Conclusions: The general opinion concerning practicability and acceptance which was created by the field test of this guideline is heterogeneous. When interpreting these results, a distortion through a strong selection bias of those motivated practices who did participate should be kept in mind. A wide participation in future field tests would be desirable to picture more reality of care.