Neuropsychiatric Disease and Treatment Open Access Full Text Article Dovepress open access to scientific and medical research O r i g i N A L r e S e A r c h Do neurologists in germany adhere to the national Parkinson’s disease guideline? Sabrina Schröder1 Daniel Kuessner2 guy Arnold 3 York Zöllner4 eddie Jones5 Marion Schaefer1 1institute of clinical Pharmacology, charité University Medicine, ccM, Berlin, germany; 2Basilea Pharmaceutica, Basel, Switzerland; 3Department of Neurology, Sindelfingen-Böblingen hospital, Sindelfingen, germany; 4Mapi Values, houten, The Netherlands; 5Adelphi group Products, Macclesfield, UK correspondence: Sabrina Schröder c harité University Medicine, institute of c linical Pharmacology, cc M invalidenstrasse 115, D-10115 Berlin, germany Tel +49 170 216 78 76 Fax +49 30 945 10 141 email sabrina.schroeder@charite.de 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 dop- amine 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 Although there is currently no cure for Parkinson’s disease, a number of treatments exist that can ameliorate symptoms, improve quality of life, and help avoid secondary complications.1 Unfortunately, the therapeutic effect of one of the mainstays of treatment, L-dopa, declines after several years of use and patients may develop late- stage motor complications2 that greatly impact on their quality of life.3 These can be either hypokinetic (eg, “wearing off ”, end-of-dose effect, dystonia) or hyperkinetic (eg, peak-dose dyskinesia, biphasic dyskinesia). The attempt to return patients to a certain degree of autonomy in mobility in their professional and daily life, especially in the later stages of the disease, continues to be a medical challenge associated with a heavy economic burden.4–6 The prevalence of Parkinson’s disease in Germany is approximately 150 cases per 100,000 inhabitants and 1,800 cases per 100,000 among people aged over 65 years.7 Germany therefore has the largest number of prevalent cases of Parkinson’s disease of any country in Europe. In 2003, the Competence Network on Parkinson’s disease (CNP), a German national network supported by the Federal Ministry of Education and Research, developed its first guideline on Parkinson’s disease according to the recommendations of the German Instrument for Methodological Guideline Appraisal. submit your manuscript | www.dovepress.com Dovepress DOI: 10.2147/NDT.S8895 Neuropsychiatric Disease and Treatment 2011:7 103–110 103 © 2011 Schröder et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.