gms | German Medical Science

Background: International cooperation between guideline developers could save resources and improve quality. The Dutch College of General Practitioners (NHG) and the Flemish organization of general practitioners (DM) initiated to collaborate on the update of a guideline on contraception.

Objectives: To share evidence summaries and to achieve consensus about the (key) recommendations.

Methods: A guideline team was composed, consisting of two staff members from NHG and two from DM. At the first meeting, we compared the existing guidelines on contraception, including the methods of development and agreed to use the Grade approach in summarizing the evidence. We formulated clinical questions and divided them among the team members. At the second and third meeting, draft versions of the guideline and areas of disagreement were discussed.

Results: We exchanged the evidence summaries and reached consensus on most of the recommendations. In contrast to NHG, DM stressed the need of monitoring blood pressure while using hormonal contraceptives and considered migraine with aura as a contraindication for prescribing hormonal contraceptives.

Discussion: The absence of a language barrier does not guarantee success, because methodological and cultural differences may still exist. Differences between Dutch and Flemish general practice concerned risk assessment and views on preventive medicine.

Implications for guideline developers: Collaboration between organizations in primary care can be successful provided that methodological and cultural differences are accepted before starting guideline development.