Do neurologists in Germany adhere to the national Parkinson’s disease guideline?

Abstract

Implementation of guidelines can improve clinical practice. The aim in this study was to investigate whether neurologists in Germany adhered to the national Parkinson’s disease guideline. Data were obtained from a cross-sectional survey of 60 neurologists. Analyses were performed on 320 patients with idiopathic Parkinson’s disease with either low grades of functional impairment (Hoehn and Yahr stage I) or higher grades of functional impairment (stage II–V) but without motor complications. The sample was divided into four groups depending on age and grade of functional impairment. For each group, a biometric parameter on the use of dopamine agonists and L-dopa was defined based on the guideline. In patients aged <70 years, the recommendation to use dopamine agonists without L-dopa (parameter 1) was observed in 53% of patients with lower grades of functional impairment, whilst recommended use of dopamine agonists in more functionally impaired patients (parameter 2) was followed to a greater extent (84%). In patients aged ≥70 years, recommendations to use L-dopa without dopamine agonists were adhered to in only 50% of less functionally impaired (parameter 3) and 52% of more functionally impaired (parameter 4) patients. In conclusion, our results indicated there was moderate but not full adherence to the guideline.

Keywords:

• Parkinson’s disease
• dopamine agonists
• L-dopa
• neurologists
• national guideline
• Germany

Acknowledgements

This study was supported by an unrestricted grant from Solvay Pharmaceuticals GmbH, Hannover, Germany, as part of a research project on the management of Parkinson’s disease in Germany conducted at the Institute of Clinical Pharmacology, Charité University of Medicine, Berlin.

Disclosure

Two of the authors were paid employees of Solvay Pharmaceuticals GmbH. None of the authors of this article have any other declarable conflict of interest.