gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Monitoring of the regional implementation of national guideline on chronic renal failure

Meeting Abstract

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  • L. Meijer - NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; MCCE Medical Coodinating Center Eemland, Amersfoort, The Netherlands
  • F. Schellevis - NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; VUmc, Department of General Practice / EMGO+ Institute, Amsterdam, The Netherlands

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP195

doi: 10.3205/12gin307, urn:nbn:de:0183-12gin3071

Published: July 10, 2012

© 2012 Meijer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: In 2009 a National Agreement (NA) was published about the collaboration between general practitioners (GPs), internists and nephrologists in case of chronic renal failure (CRF). The NA was based on the clinical practice guideline for the management of CRF patients. The aim of the NA was to stimulate regional use of the guideline.

Objectives: To provide insight into the degree of regional implementation of the guideline CRF.

Methods: Regional documents were collected by sending an invitation for an online survey to 157 different organizations. Additional documents were extracted from a referral application ('ZorgDomein') which facilitates GPs in case of referrals to hospitals. The retrieved documents were compared with the recommendations of the guideline.

Results: Three different types of documents were identified developed by different organisations: Care Groups arranging chronic care, Medical Coordinating Centers arranging care at the interface between primary and secondary care and hospitals arranging referral. We received respectively 6, 14 and 28 documents from these organizations. The hospital documents showed least concordance with the recommendations: 50% of the referral indications agree with the guideline. In the documents of the other organizations more recommendations were in accordance.

Discussion: The concordance between regional documents and the guideline varies between organizations who prepared the regional documents. The concordance between regional documents and the guideline is of great importance because these documents are nearest to the end users.

Implications for guideline developers/users: Guideline developers must take a role in supporting the use of national guidelines in cooperation with regional organizations.