Leitlinien in der Medizin und zum idiopathischen Parkinson-Syndrom

Zusammenfassung

In der Gesundheitsversorgung erlangen Leitlinien weltweit zunehmende Bedeutung, da sie vermehrt als sinnvolle und notwendige Entscheidungshilfe zur Sicherung einer qualitativ hochwertigen Gesundheitsversorgung betrachtet werden. In der Indikation Parkinson liegen derzeit qualitativ hochwertige Leitlinien unterschiedlicher Entwicklungsstufen zur Diagnostik und Therapie auf internationaler Ebene vor. In Deutschland entwickelte 2003 das Kompetenznetzwerk Parkinson die erste S2k-Leitlinie zur Diagnostik und Therapie von Parkinson-Syndromen im Auftrag der Deutschen Gesellschaft für Neurologie. Diese wurde zuletzt in 2011 überarbeitet und in tabellarischer Kurzform vorgestellt. Neben der fortlaufenden Optimierung der formalen und inhaltlichen Qualität einer Leitlinie bedarf es der Entwicklung geeigneter Implementierungsstrategien, um ihre Anwendung im ärztlichen Alltag zu garantieren.

Abstract

In medical care worldwide guidelines are gaining ever more significance as they are being recognised as a sensible and valuable tool that helps to ensure a high quality standard of health care provision. Regarding the indications for Parkinson’s disease, on an international level we can now avail ourselves of highly qualified guidelines on various developmental stages for diagnostics and treatment. In Germany in 2003, and as proposed by the Deutsche Gesellschaft für Neurologie (German Society for Neurology), the competence network Parkinson created the first S2k-guideline for diagnostic and therapeutic approaches in different types of parkinsonism. These were last revised in 2011 and arranged in an abridged tabular form. Aside from continuously improving the formal and contextual quality of a guideline, it is necessary to generate appropriate strategies of implementation to guarantee its application in everyday medical life.

Schlüsselwörter

idiopathisches ParkinsonSyndrom - Leitlinien - Therapie

Keywords

Parkinson’s disease - guidelines - therapy

• Literatur

• 1 de Rijk MC, Breteler MM, Graveland GA et al. Prevalence of Parkinson’s disease in the elderly: the Rotterdam Study. Neurology 1995; 45: 2143-2146
• 2 Ollenschläger G. Möglichkeiten und Grenzen von Leitlinien zur Reduktion von Über-, Unter- und Fehlversorgung. Chances and limits of guidelines to regulate health care services. Arzneimittelforschung 2002; 52: 332-425
• 3 Ollenschläger G, Thomeczek C, Thalau F et al. Medizinische Leitlinien in Deutschland 1994-2004. Von der Leitlinienmethodik zur Leitlinienimplementierung. Z Arztl Fortbild Qualitatssich 2005; 99: 7-13
• 4 Farquhar CM, Kofa EW, Slutsky JR. Clinicians’ attitudes to clinical practices guidelines: a systematic review. Med J Aus 2002; 177: 502-506
• 5 Larisch A, Oertel WH, Eggert K. Attitudes and barriers to clinical practice guidelines in general and to the guideline on PD in particular. A national survey among German neurologists in private practice. J Neurol 2009; 256: 1681-1688
• 6 Ollenschläger G, Thomeczek C, Kirchner H et al. The German Guidelines Clearing House (GGC). Rationale, Aims and Results. Proc R Coll Phys Edinb 2001; 31 (Suppl. 09) 59-64
• 7 Ollenschläger G, Marshall C, Qureshi S et al. Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N). Qual Saf Health Care 2004; 13: 455-460
• 8 Eggert K, Oertel WH, Reichmann H et al. Clinical practice guideline on Parkinsonian syndrome: Diagnostics and Therapy. 4th ed. Stuttgart: Thieme; 2008
• 9 Pahwa R, Factor SA, Lyons KE et al. Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006; 66: 983-995
• 10 Suchowersky O, Reich S, Perlmutter J et al. Practice Parameter: Diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006; 66: 968-975
• 11 Hortinsk M, Tolosa E, Bonuccelli U et al. Review of the therapeutic management of Parkinson’s disease. Report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorders Society-European Section (MDS-ES). Part I: early (uncomplicated) Parkinson’s disease. Eur J Neurol 2006; 13: 1170-1185
• 12 Hortinsk M, Tolosa E, Bonuccelli U et al. Review of the therapeutic management of Parkinson’s disease. Report of a joint task force of the European Federation of Neurological Sciences (EFNS) and the Movement Disorders Society-European Section (MDS-ES). Part II: late (complicated) Parkinson’s disease. Eur J Neurol 2006; 13: 1186-1202
• 13 Oertel WH, Berardelli A, Bloem B et al. Review of the therapeutic management of Parkinson’s disease. Report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorder Society-European Section (MDS-ES). Part I: early (uncomplicated). Parkinson’s disease European Handbook of Neurological Management. Volume 1. 2nd edition, edited by Gilhus NE, Barnes MP, Brainin M. : Blackwell Publishing Ltd; 2011
• 14 Oertel WH, Berardelli A, Bloem B et al. Review of the therapeutic management of Parkinson’s disease. Report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorder Society-European Section (MDS-ES). Part II: late (complicated) Parkinson’s disease. Parkinson’s disease European Handbook of Neurological Management. Volume 1. 2nd edition edited by Gilhus NE., Barnes MP, Brainin M. Blackwell Publishing Ltd; 2011