Updated DEGAM Guideline Stroke – What’s New?
DOI: 10.3238/zfa.2014.0152-0157german translation / full article
Background: In updating the DEGAM (German College of General Practitioners and Family Physicians) practice guideline „Stroke“ particularly important or not yet sufficiently developed aspects should be strengthened. In order to retain the quality level of the guideline (S3 according to the AWMF), it was further necessary to achieve consensus building concerning all occupational groups involved in the patients’ care in addition to the systematic evidence base.
Methods: The updating process was determined conforming with the DEGAM multistage concept of drafting a guideline, a systematic search for national and international guidelines and original literature for the period of 2006–2010. Special aspects of primary care were elicited using focus groups comprising family practitioners (FPs) and submitting an inquiry to a listserver of FPs. Consensus with other professional and occupational groups was ensured by holding a consensus conference under the auspices of the AWMF, which was followed by a Delphi procedure. Patients were not involved in the updating process. A renewed practice test was not performed.
Results: The stroke guideline was revised and updated thoroughly. The consensus conference allowed an inter-professional discourse about the ambulatory care of stroke patients with a special focus on primary care specific issues. The results were partially included as background information in the guideline. 12 key recommendations required a vote by a following Delphi procedure. In addition to the FPs stroke guideline a patient information is provided.
Conclusions: Ambulatory care of stroke patients is a major challenge. In particular FPs and MFA (health care assistants) coordinate the involvement of other professional groups. Through the S3-status the updated and inter-professional consented DEGAM guideline stroke is well placed within the German guideline landscape. The emphasis should now focus on the increased implementation of the guideline in primary care practice.